MULTIPLE MYELOMA

Valuable information for over 200 common illnesses

General Illness Information

Medical Term:

Multiple Myeloma

Common Name:

None Specified

Description:

Multiple myeloma is the most common malignancy of the bone. It is a malignancy beginning in the plasma cells of the bone marrow and characterized by the presence of large amounts of monoclonal immunoglobulins in the blood.

Plasma cells normally produce antibodies to help destroy germs and protect against infection. With myeloma, this function becomes impaired, and the body cannot deal effectively with infection.

The myeloma also causes multiple lesions in the bones, high calcium levels, anemia, and kidney damage.

Most patients are over 40 years old. Men and women are equally affected.

Causes:

Unknown.

Prevention:

There are no known preventive measures.

Signs & Symptoms

	Persistent and unexplained skeletal pain, especially in the back and thorax.
	Recurrent bacterial infections, especially pneumococcal pneumonias.
	Anemia, with weakness and fatigue. Weight loss. Easy bruising and tendency to bleeding.
	Some patients present with renal failure.
	Pathologic fractures, spinal collapse, sometimes leading to paralysis.
	Rarely, this will present with lymph node and liver enlargement.

Risk Factors

There are no known risk factors.

Diagnosis & Treatment

Diagnostic tests may include laboratory blood and urine studies, biopsy of bone marrow, X-rays, MRI and bone scan. The bone marrow study confirms the diagnosis.
General Measures:
	It is vital to maintain ambulation.
	Analgesics and palliative doses of radiotherapy result in significant reduction of pain.
	It is also vital to maintain adequate hydration.
	Blood transfusions of packed cells are given for symptomatic anemia.

Medications:
	Analgesics to control pain.
	Large doses of prednisone to control hypercalcemia (high level of calcium in blood).
	Allopurinol to control high serum uric acid levels.
	Antibiotics for bacterial infection.
	In some selected cases, intravenous immunoglobulinn and recombinant erythropoetin may be useful.
	Chemotherapy: Melphalan or Cyclophosphamide are usually started first line. These drugs have to be prescribed and monitored by an oncologist, and patients have to be followed closely.
	Interferon shows promise in patients who do not respond, or who relapse, and is under study.
	Various other drug regimens are also being studied.
	Also under investigation is high dose chemotherapy, total body irradiation, as well as bone marrow transplantation.

Activity:
It is vital to maintain normal activity, unless otherwise directed by your doctor.

Diet:
	No special diet.
	It is very important to maintain adequate hydration. Drink lots of fluids.

Possible Complications :
	Recurrent infections.
	Kidney failure.
	Spontaneous bleeding.
	Acute leukemia. Severe anemia.

Prognosis

The disease is progressive, but proper therapy significantly improves both the quality and duration of life. Life expectancy is related to extent and severity of disease at diagnosis.

Median survival for responding patients is 2 1/2 to 3 years.

Other

'Nothing Specified'.