Multiple myeloma is a malignant disease of the bone marrow caused by the abnormal growth and proliferation of cells that we all have in the bone marrow called plasma cells. In this case and also, without specific causes, the plasma cells acquire alterations in their functioning that cause them to multiply more rapidly than normal and their percentage increases. The plasma cells produce an abnormal protein, an abnormal immunoglobulin, which is detected in the blood in increased amounts; at the same time, the normal immunoglobulins decrease. The urine can also eliminate part of these proteins.
The plasma cells are capable of producing substances that alter the balance between bone production and destruction and, as a result, so-called lytic lesions appear in the bones.
Will I have pain with multiple myeloma?
One of the symptoms that patients with multiple myeloma may have is pain. This is due to the presence of lesions that can be seen in all the bones of the body and also due to the decalcification of the bones. Patients with multiple myeloma more frequently develop infections; from the analytical point of view, anemia is frequently seen and, on occasions, renal insufficiency, basically due to the elimination of the anomalous protein in large quantities through the urine.
Are there asymptomatic forms of multiple myeloma?
There are asymptomatic forms of myeloma: the so-called smoldering or quiescent myeloma, which is a step prior to the development of symptomatic multiple myeloma. These forms of asymptomatic multiple myeloma have traditionally gone untreated, although there are some studies that indicate that early treatment can sometimes prevent transformation to symptomatic multiple myeloma.
Is an allogeneic transplant necessary?
Multiple myeloma is an incurable disease in most cases. At the present time we have an important therapeutic arsenal with new drugs, many of which are authorized for use in our country outside clinical trials. Autologous transplantation is part of the first-line treatment of newly diagnosed myeloma patients of an age that makes them candidates for transplantation. Allogeneic transplantation can also be considered, on occasions, basically in those patients who do not respond adequately to first-line treatments. However, due to the existence of many new drugs at the present time, the number of allogeneic transplants performed in this disease has decreased significantly.