Multiple Myeloma – What is it? [WE EXPLAIN]

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Colin Powell, former US Secretary of State is dead. An American politician died as a result of complications from COVID-19 infection. According to CNN, Colin Powell was struggling with multiple myeloma, which may have contributed to fatal complications. What type of cancer is myeloma?

1. Multiple myeloma has become more common lately, especially in elderly people
2. The essence of the disease is the multiplication of plasma cells, which usually develop in the bone marrow, taking the form of lumpy foci
3. Getting an accurate diagnosis is often not easy, and the treatment proposed can vary widely
4. More information can be found on the Onet homepage

What is multiple myeloma?

Multiple myeloma is an abnormal, excessive multiplication of plasma cells (which produce antibodies and are responsible for the immunity of the human body), most often found in flat bones. This ailment is about 1 percent. of all cancers and about 10-15 percent. hematological tumors. It has been observed in recent years that the incidence of multiple myeloma is definitely increasing, and people under 55 are also increasingly ill. Patients with symptomatic multiple myeloma usually have stage II or III disease. The essence of the disease is the development of plasmocytes in the bone marrow, in the form of nodular foci, which at the same time lead to bone destruction in a specific place, up to pathological and unpredictable skeletal fractures.

Plasma cell disorders include conditions such as:

1. plasmocytic leukemia,
2. extramedullary myeloma,
3. primary systemic light chain amyloidosis,
4. POEMS syndrome and Waldenström’s macroglobulinemia.

Multiple myeloma does not usually occur in children and is diagnosed just as rarely in patients under 30 years of age.

The causes of multiple myeloma

The causes of this ailment are not fully known. However, there are certain factors that increase your risk of multiple myeloma, including:

1. people over 60 years of age,
2. low body resistance,
3. environmental factors,
4. age-related hormonal changes,
5. gender (the disease is more common in men),
6. exposure to chemical agents (e.g. solvents or dioxins),
7. exposure to radiation.

Due to the variety of environmental factors and family predispositions, finding the exact cause is very difficult. At the moment, there are no specialized tests that would detect genetic predisposition. On the other hand, a large part of research links the causes of the disease with infections with the virus: herpes (HHV-8), HIV, EBV or mutant cytomegalovirus. Multiple myeloma most likely arises from several different factors in a given patient.

Symptoms of multiple myeloma

As in other diseases of the hematopoietic system, the onset of multiple myeloma is usually not specific. Gradually progressive weakness, emaciation and increasing anemia can be observed in patients. With the development of the disease, there are pains in the bones (resulting from bone defects) that resemble rheumatism. In addition, patients experience:

1. reduced resistance to infections (including urinary and respiratory systems),
2. fractures of long bones and ribs,
3. recurring infections,
4. peripheral nerve damage,
5. kidney damage
6. coagulation disorders,
7. convulsions, coma, dizziness (due to high blood viscosity).

In patients with multiple myeloma, laboratory tests reveal an excessive amount of protein along with an increase in the protein produced by plasmocytes and a large amount of calcium in the blood.

Multiple myeloma stages

The division of multiple myeloma into different stages is made on the basis of the ISS taking into account blood parameters.

1. Stage I multiple myeloma – is a low-stage disease in which blood parameters are as follows: beta-2-microglobulin is less than 3,5 mg / dl and albumin is greater than or equal to 3,5 g / dl;
2. Stage II multiple myeloma – is an intermediate stage characterized by the following parameters: beta-2-microglobulin is less than 3,5 mg / dl, and albumin less than 3,5 g / dl, or when beta-microglobulin is between 3,5 and 5,5 .XNUMXmg / dl ‘
3. Stage III multiple myeloma is a high stage of the disease in which beta-2-microglobulin is equal to or greater than 5,5 mg / dl.

Diagnosis of multiple myeloma

The diagnosis of multiple myeloma can be determined by a doctor on the basis of:

1. blood count tests,
2. Biernacki’s reaction (revealing the amount of protein in the blood and the severity of inflammation),
3. the image of the bone marrow,
4. levels of calcium, albumin, creatinine,
5. specialist protein testing,
6. radiological examination of the skeleton.
7. Serum protein electrophoresis and concentrated urine (a test showing the amount of different types of proteins in the urine and blood).

In contrast, tests to confirm multiple myeloma are usually:

1. antibody concentration
2. specialized testing of blood proteins in the form of immunofixation,
3. assessment of the amount of monoclonal protein in urine or serum,
4. radiograph of all bones,
5. magnetic resonance imaging or computed tomography of suspicious areas and bones,
6. examination of bone marrow using an aspiration biopsy,
7. determination of serum free chain concentration.

Multiple myeloma – treatment and prognosis

Treatment of multiple myeloma is long-term and requires systematic and medical supervision. Usually, it is pharmacological treatment that inhibits proliferation, i.e. the growth of abnormal cells, but in the case of fractures, it can sometimes be orthopedic.

Due to the advancement and development of medicine, the prognosis of this disease is improving. Before the appropriate therapy is implemented, basic tests should be performed to determine the severity of the disease and the prognosis. At the moment, the golden mean in the treatment of multiple myeloma is dexamethasone therapy with thalidomide and cyclophosphamide in younger patients. However, the method known for many years and often used is chemotherapy: melphalan, prednisone, thalidomide. Oral form of therapy leads to disease remission in about 60-70% of patients. Unfortunately, chemotherapy has side effects, such as damage to stem cells. Patients with myeloma, depending on their age, are eligible for the bone marrow autograft procedure.

Excessive fatigue and weakness in the patient can be relieved by blood transfusion. In addition, it is also important to relieve bone pain so that the patient can stay physically active to strengthen the bones and improve their overall well-being.

Antibiotic therapy is initiated in patients with fever or other signs of infection. However, it should be remembered that antibiotics should be selected individually for the patient and used with caution, it is important that the infection is controlled as soon as possible. In severe infections, the patient is administered intravenous immunoglobulins. In addition to managing specific symptoms, supportive care is important. He should make sure that there are no contraindications for physical activity.

While there is no specific diet for people with multiple myeloma, it is worthwhile to eat healthy. In disease, it is also important to maintain a good mental state that affects the entire treatment process. In addition, patients should ensure regular sleep and rest, which are important for the smooth functioning of the immune system. Stress has a negative impact on the body, so you should reduce it to a minimum (at work, at home, at school). Treatment of multiple myeloma is very important, at least until the patient is in remission and stable condition.

Can the disease be prevented?

Currently, there are no methods of early prevention.

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