Symptoms, Diagnosis and Treatment of Multiple Myeloma

There are two main types of multiple myeloma: asymptomatic, which need only surveillance and usually have a very good prognosis, and symptomatic, which need treatment as soon as possible.

What is multiple myeloma?

Multiple myeloma (MM) is a tumor of the lymphatic system consisting of a proliferation of plasma cells, which produce the antibodies that defend us from infections and foreign substances that may enter our body. It represents 10% of blood tumors and 1% of human tumors with 4-6 cases per 100,000 inhabitants/year. It is estimated that about 40,000 new cases are diagnosed annually in Europe, being the cause of about 25,000 deaths per year.

Normally, plasma cells are found in the bone marrow in a small amount. In multiple myeloma they increase in excess, produce an abnormal immunoglobulin causing anemia and bone destruction due to a general loss of bone density, in addition to other symptoms.

A group of plasma cells can become tumorigenic by continuously and inappropriately producing in excess amounts of the same antibody or protein, which can be detected in the patient’s serum and urine.

Symptoms of multiple myeloma

Multiple myeloma is manifested by bone pain, which can lead to lesions or osteoporosis. It can affect any bone, although it is common in the spine, thorax, hip or extremities.

Other symptoms of multiple myeloma include fatigue and loss of appetite and weight.

Diagnosis of multiple myeloma

Initially, according to hematology specialists, multiple myeloma can be diagnosed by means of a blood or urine test in which the anonamal immunoglobulin is detected. Afterwards, a series of more specific tests must be performed, including a bone marrow test, through an aspiration puncture, and a radiological study of all the bones in the body.

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Treatment of multiple myeloma

In the case of asymptomatic indolent myelomas, only surveillance with periodic analyses is required. Symptomatic myelomas, on the other hand, require treatment as soon as possible. In addition, hydration, moderate physical exercise and pharmacological treatment are necessary to prevent bone lesions and osteoporosis, as well as the prevention of infections.

Complications of multiple myeloma

Multiple myeloma can be a disease of long evolution (between 5 and 10 years) which, although difficult to cure, can be controlled with treatment. It mainly affects older people (around 65 years of age) although it can also appear from the age of 40. It is not a hereditary disease nor does it have any known or avoidable cause.

The prognosis of multiple myeloma is marked by the response to treatment and by the presence or absence of certain genetic alterations. In addition, it depends on the appearance of the following associated complications:

  • Renal failure
  • Bone complications, such as bone fractures.
  • Neurological complications, due to compression of the spinal cord by vertebral crushing or accumulation of plasma cells.
  • Hypercalcemia, i.e. when calcium leaks abundantly from the bone into the blood.
  • Pain, caused by bone damage.