Multiple Myeloma

Multiple myeloma is a cancer that arises in one type of white cells, the plasma cells in the bone marrow, which is the soft sponge-like material in the centre of the bone. The function of plasma cells, which form part of the body’s immune system, is to fight infection by producing antibodies. When plasma cells start growing in an abnormal manner and form malignant tumours, they stop producing antibodies and the body loses resistance to infection. As a result the patient becomes prone to colds, coughs, flu, pneumonia and other infections.

Symptoms

The first sign of multiple myeloma is pain in the bone, usually backache. Later the pain may shift to the ribs, neck or pelvic areas.

By crowding out the red cells and platelets in the bone marrow, the patient can become anaemic and tired, as well as having bleeding gums and frequent nose bleeds. Other late symptoms are bone fractures and painful pressure on the spinal cord.

Diagnosis

The diagnosis is made from blood and urine tests, which show the presence of abnormal proteins. Examination of the bone marrow can detect increased numbers of cancerous plasma cells. The specimen of tissue is obtained by means of a bone marrow biopsy, during which a special needle is inserted into the breast bone or pelvic bone and a small amount of tissue is taken for examination in the laboratory. X-rays of the skeleton show up the areas of bone invaded by the malignant plasma cells.

Treatment

Multiple myeloma is usually treated by chemotherapy because there are drugs available which are sufficiently specific to damage malignant plasma cells before harming normal tissues. Where bone has been invaded by plasma cells, local radiotherapy is very beneficial in that it removes the malignant plasma cells and allows the bone to harden again. This prevents fracture and promotes healing where the bone has already cracked.

Cures are rare, but a temporary recovery can often be obtained by chemotherapy. Periodic examinations of the blood, the bone marrow and urine are essential to confirm the continued absence of diseased cells and abnormal proteins. Sometimes the recovery is only partial and one or more symptoms of myeloma persist throughout the prolonged treatment.