Essential Insights Before Undergoing Multiple Myeloma Treatment

Key Information to Consider Before Managing Multiple Myeloma

Multiple myeloma is a cancer originating in plasma cells within the bone marrow. These cells produce antibodies that fight infections, but when they become cancerous, they crowd out healthy blood cells, disrupting normal function. Although there is no cure, treatments aim to control symptoms and enhance quality of life. The disease stage influences treatment approaches, which may include chemotherapy, targeted therapy, or immunotherapy depending on progression.

What Are the Disease Stages?
If untreated, multiple myeloma can progress through several stages, each with distinct characteristics.

Stage I:

In early Stage I, only a small number of cancerous plasma cells are present, measured by plasma cell index. Hemoglobin levels may be slightly below normal, and bone scans reveal localized damage. Calcium levels are often low, reflecting bone deterioration. Additional tests, including blood and urine analysis, may detect abnormal antibodies or proteins associated with the disease.

Stage II: An intermediate phase characterized by increased myeloma cell proliferation. Features overlap between Stage I and Stage III, with variable symptom severity.

Stage III: The most advanced stage features rapid multiplication of malignant plasma cells, leading to significant blood and bone abnormalities. Hemoglobin becomes very low, calcium levels rise due to extensive bone destruction, and abnormal proteins accumulate in blood and urine. Treatments like immunomodulators, including pomalyst, are typically employed. Stage III often involves metastasis, affecting lymph nodes and distant tissues.

Are All Stages Equally Life-Threatening?

Early, localized stages have more treatment options and higher survival rates due to their limited progression.

As the disease advances, spreading affects immune function, making treatment more challenging and prognosis poorer.

Stage III, usually a terminal phase, may relapse despite interventions, with fewer options available, raising the risk of death.

Causes of Multiple Myeloma

Genetic abnormalities in bone marrow cells can lead to excess plasma cell growth, a key factor in disease development.

The hormone interleukin-6, produced by dendritic cells in the marrow, stimulates plasma cell proliferation when overexpressed.

Mutations in oncogenes like Myc contribute to early plasma cell tumors.

Loss of the 17th chromosome, common in these patients, can make the disease more resistant and aggressive.

How Is Multiple Myeloma Diagnosed?

Blood tests: Complete blood count (CBC) assesses red and white cells, while blood chemistry tests evaluate kidney function (creatinine), calcium, and albumin levels.

Immunoglobulin analysis: Tests identify elevated specific antibodies such as IgG or IgA, indicative of myeloma.