Essential Insights Before Beginning Treatment for Multiple Myeloma

Learn essential facts about multiple myeloma, including its stages, causes, diagnosis, and treatment options. This guide helps patients understand the progression of the disease and the importance of early diagnosis for better management and prognosis.

Essential Insights Before Beginning Treatment for Multiple Myeloma

Multiple myeloma is a form of blood cancer originating in plasma cells within the bone marrow. These cells are crucial for producing antibodies to combat infections. When cancer develops, it crowds out healthy blood cells, leading to various health issues. Although a cure remains elusive, medical treatments aim to control symptoms and enhance quality of life. The stage of the disease significantly influences the treatment approach, with different strategies applied at each stage.

Understanding the stages of multiple myeloma
Without proper treatment, the condition can progress through multiple stages:

Stage I:
In early stages, only a small fraction of plasma cells are malignant, which can be quantified via plasma cell index. Hemoglobin levels are slightly diminished, and minor bone damage is visible on X-rays, often coupled with low calcium levels. Blood and urine tests may reveal abnormal proteins and antibodies.

Stage II:
This intermediate phase involves an increase in malignant plasma cells. Features blend characteristics from both Stage I and Stage III.

Stage III:
At this advanced stage, cancer cells proliferate rapidly, severely reducing hemoglobin levels. Bone destruction releases calcium into the bloodstream, raising calcium levels. Elevated antibody proteins appear in blood and urine. Treatment using immunomodulators like pomalyst is common. This stage often involves metastasis, spreading cancer to lymph nodes and other tissues.

Are all multiple myeloma stages terminal?

Early stages generally have more treatment options due to their localized nature and better prognosis, leading to higher survival rates in Stage I.

Progression causes cancer to affect larger areas, weakening the immune system and decreasing survival chances.

Stage III is typically considered terminal, often with relapsed disease. Limited treatment options exist at this point, increasing the risk of mortality.

Causes of multiple myeloma

Abnormalities in bone marrow plasma cells can trigger excess growth, a common cause.

The hormone interleukin-6, released by dendritic cells in the bone marrow, stimulates plasma cell activity; overproduction can lead to myeloma.

Genetic mutations, such as abnormalities in oncogenes like Myc, also contribute to early plasma cell tumors.

One notable marker is the absence of chromosome 17, which can make the disease more resistant and aggressive.

Diagnosis of multiple myeloma

Blood count: The CBC evaluates red and white blood cell counts and platelets. High plasma cell levels can cause lower counts overall.

Blood chemistry: Tests assess kidney function (creatinine), calcium levels (often elevated in advanced stages), and albumin levels, which tend to decrease in myeloma.

Immunoglobulin quantification: Measuring specific antibodies like IgA, IgD, IgE, IgG, and IgM helps identify abnormal antibody production associated with myeloma.