Multiple Myeloma Causes, Symptoms, and Treatments

Multiple myeloma is a plasma cell disorder. These related conditions often progress from noncancerous (benign) to cancerous (malignant multiple myeloma).

Monoclonal gammopathy of undetermined significance (MGUS)

MGUS is when plasma cells make too many copies of the M protein. It's a benign condition that can turn into multiple myeloma.

Almost everyone who has multiple myeloma had MGUS first.

Isolated plasmacytoma

This type of blood cancer is a single mass of plasma cells in the bone marrow.

It may turn into myeloma.

Extramedullary plasmacytoma

This type occurs when plasma cell tumors grow outside the bone marrow.

Multiple myeloma

This type occurs when there are two or more plasma tumors in the bone marrow.

Smoldering multiple myeloma

These plasma cell tumors don't cause any symptoms.

It can become full-blown multiple myeloma, so your doctor will watch you closely.

Myeloma starts when abnormal plasma cells, or myeloma cells, build up in the bone marrow and form tumors.

Like any cancer, it's due to genetic changes that lead to out-of-control growth. But doctors don't know of any specific causes that trigger these changes.

Most likely, multiple myeloma has a variety of causes. These may include environmental factors like radiation exposure.

It also seems to run in families. In these cases, it may be due to inherited genetic changes.

Plasma cell disorders like those above can give rise to other conditions, such as:

• Amyloidosis. Proteins clump or fold into plaques that collect in the body. These plaques can damage other organs.
• Anemia. The growth of plasma cells can crowd out healthy cells that make blood components. Anemia is when you don't have enough red blood cells.
• Hypercalcemia. Damage to the bones can release calcium into the blood. Too much calcium can cause digestive issues and fatigue.
• Other blood cell disorders. When the bone marrow can't make enough healthy white blood cells, it can lead to infection.

If you have myeloma, you may not have symptoms until the plasma tumors start affecting nearby tissues and organs.

Common signs and symptoms of myeloma include:

• Bone fractures.
• Bone pain, often in the ribs or lower back.
• Increased infections.
• Kidney damage.
• Too much calcium in the blood (hypercalcemia).
• Unexplained bleeding.
• Weakness.

You should see your doctor if you have bone pain, unexplained bleeding, or weakness.

Doctors often suspect multiple myeloma when routine blood tests reveal anemia or other abnormal results.

In that case, your doctor will order more tests like:

• Blood tests. Blood tests will check for proteins and cells to see how well your kidneys and other organs work.
• Bone marrow biopsy. Your doctor will insert a needle into your pelvic bone to take some bone marrow. Doctors will study the marrow for myeloma cells.
• Imaging tests. Your doctor will need detailed pictures of your bones and organs to learn if myeloma has damaged them. These tests may include a mix of x-rays, CT, MRI, and PET scans.
• Urine tests. Your doctor may want to test your urine for M-proteins. You may need to collect it over 24 hours.

Doctors have many ways to treat multiple myeloma. Your doctor will suggest a treatment plan based on your unique needs and how advanced your disease is.

Treatments include:

• Chemotherapy.
• Immunotherapy.
• Radiation.
• Stem cell transplant.
• Targeted therapy.

The U.S. Food and Drug Administration has approved many new myeloma treatments recently. Researchers are also studying new myeloma drugs, which may be a treatment option.

Doctors consider multiple myeloma a chronic, uncurable disease. You may have periods of active disease followed by periods of feeling well.

Your long-term outlook, or prognosis, depends on:

• How advanced your multiple myeloma is.
• How well you respond to treatment.
• Your health.

People today live longer with multiple myeloma than ever, thanks to new therapies.