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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Multiple Myeloma

What is it?

Multiple myeloma is a form of cancer resulting from the overproduction of a single clone of plasma cells, a type of white blood cell produced in the bone marrow. Plasma cells proliferate in the marrow, infiltrate adjacent bone tissue, and may spread throughout the skeleton, resulting in bone pain and fractures of fragile, brittle bones. (Some patients develop a single plasma cell tumor, known as a plasmacytoma, in a bone or elsewhere.) Proliferation of plasma cells interferes with the formation of red cells (causing anemia), platelets (increasing the risk of bleeding), and white cells (increasing susceptibility to infection). Myeloma also involves the production of large amounts of a type of immunoglobulin (antibody) termed myeloma protein.Multiple myeloma most often affects those over age 60 and without treatment is usually fatal within two years of diagnosis. Although there usually is no cure, treatment can prolong life and improve the patient's quality of life.

What Causes It?

  • The cause of multiple myeloma is unknown, although genetic factors may play a role.
  • Risk increases with age and exposure to radiation.

Prevention

  • Try to minimize exposure to radiation.

Diagnosis

  • Patient history and physical examination.
  • Blood tests for myeloma protein, calcium levels, and measurement of the number of red cells, platelets, and white cells.
  • Urine examination for myeloma protein.
  • Bone marrow aspiration or biopsy, usually taken from the hip.
  • X-rays of the skull, chest, spine, or other pain sites.

How to Treat It

  • Stay as active as possible to maintain bone strength. Because bones may be brittle, your doctor or physical therapist should supervise any program of activity.
  • A combination of chemotherapeutic agents, often including corticosteroids (usually prednisone), is used to destroy cancerous cells.
  • Radiation therapy is effective for plasmacytomas.
  • Radiation is also used to relieve bone pain and spinal cord compression.
  • Surgery may be necessary to repair bone fractures.
  • Plasmapheresis, a procedure that filters excess waste products out of the blood artificially, may be performed in the event of an increase in the blood viscosity due to excess protein, produced by myeloma cells (hyperviscosity syndrome).
  • Analgesics are administered to reduce pain.
  • Antibiotics may be prescribed to treat associated bacterial infections.

When to Call a Doctor

  • Call a doctor for bone pain or for the emergency symptoms of hypercalcemia or kidney failure.