Journal of Clinical & Experimental Pathology
Open Access

Myeloma is a type of cancer that affects plasma cells, and white blood cell which are found in the bone marrow. These plasma cells are responsible for producing antibodies that help the body fight infections. When myeloma develops, these plasma cells become abnormal and multiply uncontrollably, crowding out healthy blood cells in the bone marrow. This condition often leads to weakened bones, anemia, kidney damage, and impaired immune function. Myeloma is considered a rare cancer, accounting for approximately 1% of all cancers and 10% of all blood cancers. However, it is the second most common blood cancer, following non-Hodgkin lymphoma. The exact cause of myeloma is not well understood, but certain risk factors have been identified. Myeloma is more common in older adults, with the average age of diagnosis being around 65 years old and mens are slightly more likely to develop myeloma than women. African Americans are at a higher risk of developing myeloma compared to other racial groups.

Individuals with a family history of myeloma or certain other plasma cell disorders may have an increased risk. Some conditions, such as Monoclonal Gammopathy of Undetermined Significance (MGUS), are considered precursors to myeloma. The signs and symptoms of myeloma can vary depending on the stage of the disease and the organs affected. Myeloma often causes bone pain, especially in the back, ribs, and hips. This pain may worsen with movement or pressure. Anemia, a condition characterized by low red blood cell count, can lead to weakness, fatigue, and shortness of breath. It can impair kidney function, leading to symptoms such as increased thirst, decreased urine output, and swelling in the legs and ankles. Since myeloma affects the immune system, individuals may experience recurrent infections, such as pneumonia or urinary tract infections. Myeloma can cause nerve damage, leading to symptoms like numbness, tingling, or weakness in the limbs. Some individuals may experience significant weight loss without trying.

Diagnosing myeloma typically involves a combination of medical history review, physical examination, and various tests. Blood tests can detect abnormal levels of certain proteins, such as monoclonal antibodies or immunoglobulins, which are produced by myeloma cells. Urine tests may reveal the presence of abnormal proteins, such as Bence Jones proteins, which are often excreted by myeloma cells. A sample of bone marrow is taken from the hipbone or another large bone and examined under a microscope to look for abnormal plasma cells. X-rays, CT scans, MRI scans, or PET scans may be used to assess bone damage and detect any tumors or lesions. Once diagnosed, myeloma is staged to determine the extent of the disease and guide treatment decisions. The most commonly used staging system for myeloma is the International Staging System (ISS), which takes into account levels of certain proteins in the blood and other factors.

Low levels of abnormal proteins and no other signs of advanced disease. Intermediate levels of abnormal proteins or other signs of disease progression. High levels of abnormal proteins and other indicators of advanced treatment for myeloma aim to control the disease, relieve symptoms, and improve quality of life. The choice of treatment depends on factors such as the patient's age, overall health, stage of the disease, and any underlying complications. Chemotherapy drugs are used to kill cancer cells and slow disease progression. Drugs such as lenalidomide and pomalidomide help to enhance the immune system's ability to fight cancer. Drugs like bortezomib and carfilzomib interfere with the growth and survival of myeloma cells.

Corticosteroids, such as prednisone or dexamethasone, may be used to reduce inflammation and suppress the immune system. High-dose chemotherapy followed by a stem cell transplant may be recommended for younger, otherwise healthy individuals. Monoclonal antibodies and other targeted therapies may be used to specifically target and attack myeloma cells. Radiation therapy may be used to relieve bone pain or shrink tumors in specific areas. The prognosis for myeloma varies depending on several factors, including the stage of the disease, response to treatment, and overall health of the patient. While myeloma is generally considered incurable, many patients can achieve remission and enjoy a good quality of life with ongoing treatment and management of symptoms. However, myeloma can be a chronic condition with periods of remission followed by relapse, requiring long-term management and monitoring. There is currently no cure for myeloma, advances in treatment options have significantly improved outcomes for many patients. Early detection, accurate diagnosis, and timely initiation of appropriate treatment are essential for managing myeloma effectively and improving patient outcomes.