- Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. The main function of plasma cells is to produce antibodies or immunoglobulin.
- Normally the amount of plasma cells will make up approximately 2-3% of the bone marrow. However, multiple myeloma causes this number to increase to more than 10%, as well as causing malfunctions in immunoglobulin production. It leads to abnormal proteins referred to as M protein or Monoclonal protein which are harmful to the body’s organs for example it can lead to osteoporosis, fractures, kidney failures, and alters the level of calcium in the body to dangerous levels.
- It is most common in individuals aged between 60-70 and is uncommon in individuals below the age of 40
- Sometimes the plasma cells may form a tumor located outside the bone marrow. This is referred to as Plasmacytoma and is most often found in the spine, sternum, or ribs.
- Although there is currently no cure for multiple myeloma, it can still be treated to an extent due to advancements in medicine (in past 10 years) that has allowed victims to extend their life span despite the condition.
- Exact cause of myeloma is unknown
- Patients with abnormal protein (Monoclonal Gammopathy of Undetermined Significance – MGUS) are at a higher risk of 1% annually
- Paleness, weariness, and abnormal bleeding
- Pain in bone, and fractures
- High levels of calcium in blood can lead to confusion, constipation, and incontinence
- Drastic weight loss
- Blood count to determine blood platelet count and presence of Plasma cell leukemia
- Blood tests to determine level of M protein and immunoglobulin and serum free light chain
- Test to determine kidney function, calcium and other minerals
- Bone marrow test to determine amount of plasma cells and chromosomes for treatment plan
- X-ray (Skeleton Survey
- Urine test to determine level of M protein
- Main treatment method is chemotherapy, selection of which will be determined by age and physical readiness of the patient. Novel therapy has proven to be effective in treating multiple myeloma compared to traditional chemotherapy. Other new medication includes Proteasome inhibitor and immunomodulators which can help to prevent recurrence of the disease.
- Autologous stem cell transplantation – may be provided following chemotherapy consideration is given for patients below the age of 65 (physically fit without pre-existing conditions). To determine suitability patients over 65 will require a physical evaluation and doctor’s discretion.
- Ablation- in cases of Plasmacytoma, has spread to other organs or severe pain from fracture
- Medication to improve bone strength such as Biphosphanate to prevent further damage.
- Cement injection of balloon stent – Kyphoplasty or Vertebroplasty to reduce pain
- A medical team specialized in hematological malignancy on hand to provide comprehensive and continuous consultation and treatment. This may include chemotherapy or stem cell transplant
- The Blood and Marrow Stem Cell Transplant Center is well-equipped to offer services that meet international standards
- Multidisciplinary team versed in many fields such as infectious diseases, lung disease, or heart disease on hand to provide treatment for any complications during and after chemotherapy
- Specialized nurse team at chemotherapy unit is well-experienced, prepared to deal with any complications that may occur during chemotherapy.
Dr. Nuchanan Areethamsirikul