Myeloma
What is myeloma?
Myeloma (also called multiple myeloma) is a malignant condition (cancer) of the bone marrow. The cancer develops from plasma cells, which are part of the immune system. The normal role of plasma cells is to make the antibodies that protect us from infection. If we have a vaccine, the vaccine stimulates our immune system to make antibodies against the infection for which the vaccine is designed. In patients with myeloma, the cancerous plasma cells continue to make antibodies; however, as the myeloma plasma cells have overgrown, there are excessive quantities of antibodies in the blood. For this reason, myeloma is often diagnosed because of high antibody levels in the blood. The progress of myeloma and the success of treatment can be followed by measuring the levels of the myeloma antibody (also known as a monoclonal protein or monoclonal band). The myeloma antibodies can also leak out into the urine; therefore, urine tests are frequently undertaken as an additional measure of the progress of the myeloma.
In addition to high levels of myeloma antibody in the blood, patients with myeloma can develop the following problems, all of which would indicate that treatment is required:
- Anaemia - The myeloma plasma cells in the bone marrow can inhibit the normal growth of red blood cells, which normally occurs in the bone marrow.
- Holes in the bones or bone pain - The cancerous myeloma plasma cells eat holes (called lytic lesions) in the bone. This can cause the bone to fracture or cause pain in the bone.
- Kidney failure - The myeloma antibodies can obstruct the plumbing in the kidneys leading to kidney failure.
- High blood calcium - When the myeloma plasma cells cause bone damage, the calcium that was in the bones is dissolved into the blood, causing high levels calcium in the blood.
How is myeloma diagnosed?
The diagnosis of myeloma is made by the combination of blood and urine tests, X-rays of the whole skeleton and bone marrow biopsy (to confirmed increased numbers of plasma cells). These tests help distinguish myeloma from other conditions that may initially appear similar to myeloma, for example amyloidosis or "monoclonal gammopathy of uncertain significance", also known as MGUS.
How is myeloma treated?
Not all patients diagnosed with myeloma need treatment; but if there is anaemia, high blood calcium, kidney failure, bone pain or bone damage, then treatment is generally started immediately. There is a range of treatment options.The treatment chosen depends on your age, the symptoms or complications you have from the myeloma, any other health problems you have, and personal issues such as your life style and where you live. Younger patients may be treated with intravenous chemotherapy and stem cell transplantation. Older patients are generally treated with treatments taken orally such as prednisone, melphalan and thalidomide. Involvement in clinical trials can increase the range of treatment options available.
In our clinic we discuss the treatment options relevant to each individual patient so that patients are able to be involved in the decision making process and can make informed choices. The particular options that are most suitable for you will be discussed with you. Some of these options are described in more detail in the links provided on this page. We also provide hard copies of the patient information booklet provided by the Leukaemia Foundation.
Additional Information
Additional information about myeloma and it's treatment is available in the following links.
Leukaemia Foundation
The Leukaemia Foundation is an Australian Organisation that supports patients and research into leukaemia and related diseases, which includes myeloma. This link provides information about myeloma prepared by the Leukaemia Foundation.
Click here for information about myeloma provided by the Leukaemia Foundation.
UptoDate
UptoDate is an online text book used by many specialists around the world. The text also provides excellent sections with information for patients. The following link provides information from Uptodate for patients about myeloma.
Myeloma symptoms and diagnosis
International Myeloma Foundation
The International Myeloma Foundation is an American based organisation that supports patients and research into myeloma. The following links provide information about myeloma and various treatment options. Some of the information is very detailed, but the source is reliable and accurate. Some aspects of treatment in America may not be the same in Australia.
Myeloma Patient Information booklet
Information about:
- Dexamethasone and other steroids
- Revlimid (Lenalidomide)
- Thalidomide
- Stem Cell Transplantation for myeloma
