Multiple Myeloma

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After completing a thorough lab analysis of your recent biopsy, a specialized doctor called a pathologist reported a diagnosis of multiple myeloma, which is a type of cancer that develops from plasma cells. The average age the condition begins is in the mid-60s, and men are affected more often than women.

About the Condition

Leuk Diag 12-21-09The soft inner tissue that fills the cavities of bones is called bone marrow. In adults, certain bones such as the skull, shoulder blades, ribs, pelvis and vertebrae (backbones) contain red bone marrow, which is the site of the body’s blood stem cells. These cells develop into blood-forming cells that then produce various components of the blood such as red and white blood cells and platelets. (Blood stem cells are not the same as embryonic stem cells.)

Plasma cells are a type of white blood cell that make proteins called antibodies, which are part of the immune system that helps protect the body from harmful substances such as bacteria.

Myeloma is a type of cancer that occurs when plasma cells do not develop and die in a normal manner. The abnormal cells collect in the bone marrow and may damage the solid part of a bone, causing bone pain and fractures. Multiple myeloma is when more than one bone is affected, and plasmacytoma is the name when there is only one focus of disease.

The extra abnormal proteins made by myeloma cells can cause complications such as an increased risk of infections due to reduced immunity, impaired kidney function, headaches, and impaired vision. Sometimes they may form deposits that cause organ damage, called amyloidosis.

There are three general stages of multiple myeloma — I, II and III — based on blood chemistry measurements and how much the bones and other organs have been affected by the cancer. Your doctor can tell you more about your particular cancer subtype and stage.

Treatment Options

Deciding on a treatment plan for multiple myeloma can be complex and depends upon a variety of factors such as your age, general health condition, stage of cancer and personal preferences. The following treatment possibilities are available:

Watchful Waiting – Some patients with early or Stage I multiple myeloma decide not to pursue active therapy for their cancer but rather adopt a “watch and wait” tactic, avoiding the side effects of standard treatments.

Chemotherapy – The use of anti-cancer drugs, or chemotherapy, provides a way to kill myeloma cells systemically (throughout the body) via the bloodstream. Often a combination of several drugs is given, which varies based on the stage of cancer.

Targeted Therapy – This newer form of anti-cancer therapy targets specific abnormalities within just the cancer cells to slow or stop their growth using drugs such as bortezomib.

Biologic Therapy – In certain cases, therapy that employs man-made biologics (i.e., synthetic proteins) such as interferon is used to treat multiple myeloma.

Other Drugs – Bisphosphonates are drugs that can help slow down the bone weakening process in multiple myeloma patients. Thalidomide and lenalidomide are often used due to various beneficial effects that fight the cancer. Corticosteroids are also used at times to treat multiple myeloma.

Radiation Therapy – Radiation therapy provides a way to shrink or destroy masses of cancer cells as well as to reduce pain. For multiple myeloma, external beam radiation is used, in which a high energy X-ray machine directs radiation at the tumor.

(Hematopoietic) Stem Cell Transplant – Stem cell transplant involves the transfer of specific blood-forming (hematopoietic) cells after high-dose chemotherapy (and at times added radiation therapy). Cancer cells in the body along with healthy blood-forming cells in the bone marrow are destroyed by the chemotherapy, which is given following the harvest of transplant cells from the bone marrow or blood of the patient (autologous transplant). This usual method has lower risks than allogeneic transplant, when cells come from a matched donor. The harvested cells are frozen and later thawed for infusion into the body to help the bone marrow regenerate.

Plasmapheresis – Some patients who experience a buildup of myeloma proteins and thickening of the blood (hyperviscosity) receive plasmapheresis, which may help with symptoms but does not kill cancer cells. The process involves removing blood from the body via a vein, separating the plasma from the blood cells, discarding the plasma (which contains abnormal protein) and returning the blood to the patient, with the plasma replaced by a salt solution or donor plasma.

You may also consider participating in clinical trials. These investigative studies help doctors learn about new treatments and better ways to use established treatments. Talk with your doctor about the possibility of taking part in a clinical trial in your area.

What You Can Do

You can choose to take an active role in your health and well-being. Learn as much as you can about your condition and have a list of questions ready each time you meet with your doctor. Join a cancer support group, and talk with your family, friends, clergyperson or counselor as you feel comfortable. Also be sure to eat well, including protein to keep up your strength, drink plenty of fluids and stay as active as you can.

Additional Resources

American Cancer Society, 800.227.2345, www.cancer.org
Leukemia & Lymphoma Society, 800.955.4572, www.leukemia-lymphoma.org

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 8.12