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Multiple Myeloma

What is Multiple Myeloma ?

Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahler's disease after Otto Kahler) is a type of cancer of plasma cells, immune system cells in bone marrow that produce antibodies.

Multiple myeloma is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance (MGUS) to plasma cell leukemia. First described in 1848, multiple myeloma is a disease characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein.

Myeloma can be asymptomatic or insidious. The disease can cause systemic ailments, including infections and renal failure, and local catastrophes, including pathologic fractures and spinal cord compression.

Causes of Multiple Myeloma

Although the cause of multiple myeloma isn't known, genetic factors and occupational exposure to radiation have been linked to the disease.

Signs & Symptoms of Multiple Myeloma

  • Excessive thirst and urination
  • Constipation
  • Decreased numbers of red or white blood cells (anemia, infections)
  • Nausea
  • Loss of appetite
  • Mental confusion
  • kidney failure (increased creatinine)
  • Weight loss

Diagnostic Tests

Complete blood count shows moderate or severe anemia. The differential may show 40% to 50% lymphocytes but seldom more than 3% plasma cells. Rouleau formation, often the first clue, is seen on differential smear and results from elevation of the erythrocyte sedimentation rate.

Urine studies may show protein urea, Bence Jones protein, and hypercalciuria. Absence of Bence Jones protein doesn't rule out multiple myeloma, but its presence almost invariably confirms the disease.

Bone marrow aspiration reveals myelomatous cells (abnormal number of immature plasma cells); 10% to 95% instead of the normal 3% to 5%.

Serum electrophoresis shows an elevated globulin spike that is electrophoretically and immunologically abnormal.

X-rays during the early stages may reveal only diffuse osteoporosis. Eventually, they show multiple, sharply circumscribed osteolytic (punched out) lesions, particularly on the skull, pelvis, and spine-the characteristic lesions of multiple myeloma.

Excretory urography can assess renal involvement. To avoid precipitation of Bence Jones protein, iothalamate or diatrizoate is used instead of the usual contrast medium.

Treatment

At this time, multiple myeloma is not considered curable although current treatments may produce a complete remission in some patients (disappearance but not cure of the disease). The goals of treatment are to eliminate myeloma cells, control tumor growth, control pain, and allow patients to have a normal, active life and minimize complications as they occur. Doctors generally recommend that patients with multiple myeloma stay as active as possible to help preserve the calcium in their bones and drink plenty of fluids to help with kidney function.

As said eariler there's no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity. The appropriate treatment depends on your needs, medical status and general health. Standard treatment options include:

Stem cell transplantation. This treatment involves using high-dose chemotherapy along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow.

Radiation therapy. This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth

Chemotherapy.Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy travel through the bloodstream to cancer cells throughout the body.

Surgery - Because multiple myeloma is usually widespread and scattered, surgery is not used to treat myeloma. It may be used to obtain a diagnosis or relieve pressure from a plasmacytoma on the spine or other organs.



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