Multiple Myeloma: Understanding The Most Common Bone Marrow Cancer

Multiple myeloma, is a type of blood cancer that affects plasma cells present in the bone marrow. Plasma cells produce antibodies that protect our body from various infections and diseases. In multiple myeloma, these plasma cells multiply abnormally, get accumulated inside the bone marrow, and produce too much protein called paraprotein, which affects the formation of healthy plasma cells and weakens the body's immunity. This chronic disease accounts for about 10 to 15 per cent of all blood cancers and is commonly diagnosed in people over the age of 50, with slightly higher prevalence in men than women. It is estimated that there are around 10,000 to 15,000 new cases of multiple myeloma diagnosed every year in India. There is a growing concern about the increasing prevalence of multiple myeloma in urban areas, surpassing the number of cases reported in rural areas.

Causes and effects of multiple myeloma

While the causes of multiple myeloma are not fully understood, some studies have shown that certain genes in DNA can cause excessive growth of plasma cells that later become cancerous cells. Additionally, some cells in the bone marrow produce a chemical substance called interleukin 6, which contributes to the development of multiple myeloma.

Multiple myeloma primarily affects four organs, commonly referred to as "CRAB":

1. Hyper-Calcemia: Multiple myeloma increases calcium levels in the body, which affects the functioning of the heart and brain, weakens bones, and can cause kidney stones, drowsiness, confusion, inappropriate behavior, coma, and abdominal pain.

2. Renal abnormalities: Multiple myeloma hinders the functioning of the kidneys, leading to the accumulation of waste, excess fluid and electrolytes, decreased urine, and even unconsciousness.

3. Anemia: Multiple myeloma reduces the production of red blood cells in the blood, leading to weakness, fatigue, and breathlessness.

4. Bone lesions: Multiple myeloma weakens bones, leading to body pain, fractures, damaged nerves, or spinal cord due to fractures in the spine.

Risk Factors

There are several risk factors for multiple myeloma, including age (people of age above 50 years are more susceptible to get the disease), gender (men are more prone in comparison to women, family history, exposure to harmful substances such as chemicals and radiation, and obesity.

Treatment

While there is currently no permanent cure for multiple myeloma, several treatments can help reduce symptoms and slow down the progression of the disease. Treatment options include targeted therapy, biological therapy, chemotherapy, corticosteroids, bone marrow transplant, autologous stem cell transplant (ASCT), and radiation therapy. ASCT is the most advanced and significant treatment option currently available. In this therapy, chemotherapy is used to destroy cancer cells, and healthy cells are extracted from the patient's body or a healthy donor and replaced with cancer cells. Healthy cells then produce healthy blood and restore all blood cells, improving the patient's quality of life and increasing their lifespan.

However, awareness among patients about ASCT is still low, and only 5 to 8 percent of patients benefit from it. Therefore, there is a need for more efforts to raise awareness and bridge the gap between patients and ASCT to improve their lives.

Multiple myeloma is a complex and challenging disease, but there are treatments available that can help manage the symptoms and improve patients' quality of life. Apart from that patients should also adopt a healthy lifestyle, avoid exposure to harmful substances, and undergo regular check-ups to detect the disease at an early stage. With ongoing research and advancements in treatment options, there is a hope for a brighter future for multiple myeloma patients.

(Dr Nitin Sood, Director - Hemato Oncology & Bone Marrow Transplant, Medical and Haemato Oncology , Cancer Institute, Medanta, Gurugram)

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