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Multiple Myeloma Is A Type Of Blood Disorder
Multiple myeloma is a type of blood disorder that originates from the plasma cells in the bone marrow. Multiple myeloma is also called plasma cell myeloma or simply Kahler’s disease, named after Otto Kahler an expert pioneer in the disease. Multiple myeloma is a cancer of plasma cells which normally would produce healthy antibodies that help fight infections. But in this case, these plasma cells turn cancerous and accumulate in the bone marrow and interfere with the production of normal healthy blood cells. Instead, these cancerous plasma cells produce large quantity of one abnormal toxic antibody called paraprotein or M protein which can cause kidney problems.
The occurrence of multiple myeloma is 10 to 40 per 1,000,000 a year. It is more prevalent in males of African and Native Pacific Islanders. Asians have the lowest rate of contracting multiple myeloma. From past statistical data, the peak age group for the onset of multiple myeloma is between 65 and 70 years of age. However, latest statistical data seem to indicate an increase in cases of multiple myeloma amongst younger patients. With conventional treatments, survival rate is not very encouraging, ranging from 3 to 7 years or longer with more advanced treatments.
Multiple Myeloma Can Affect Many Parts Of The Body
For a multiple myeloma patient, the bone marrow is being compromised resulting in the depletion of normal bone marrow caused by cancerous cells which prevent production of normal red blood cells. A condition called anemia will result in the patient feeling lethargic.
Bone breakdown results in bone pain which usually involves the spine and ribs. Bones become weak and can fracture easily. Bone breakdown also causes abnormal release of calcium into the blood stream. The multiple myeloma patient will experience vague abdominal pain or discomfort, and constipation. In addition, the patient's kidneys may be affected. This is due to the excessive proteins secreted by the cancerous cells into the blood stream. This may result in kidney failure and may require dialysis treatment, which is a lengthy and expensive procedure. The patient will also have poor appetite and experience nausea.
Nerves of the patient may be affected with the problem called peripheral neuropathy. They may also experience problems with sensation, movements, and feel numbness and weakness of the limbs.
Immune system of the patient becomes weakened because of the decrease in the level of antibodies and the patient will be more susceptible to frequent infections.
How Is Multiple Myeloma Diagnosed
Multiple myeloma is sometimes difficult to diagnose because there is no one specific test or symptom that can definitely confirm the diagnosis. Normally multiple myeloma tests are done only after the patient complains about feeling tired, having vague low back pain, a bony fracture that has happened easily or in severe cases when the patient has already developed renal failure or kidney problem.
There are several tests that need to be conducted before multiple myeloma can be confirmed.
Blood tests: Full blood count and antibody level, blood biochemistry to determine renal function and calcium levels.
Urine test: To determine whether there is any abnormal level of protein in the urine.
Radiological imaging: X-rays/CT scans/MRIs to establish any nerve compression or spine fracture.
Bone marrow examination: To determine any presence and severity of plasma cell infiltration in the bone marrow.
Classification And Staging Of Multiple Myeloma
Classification of multiple myeloma is usually classified by the type of abnormal antibody or paraprotein that the body produces. In theory, multiple myeloma can produce all classes of immunoglobulin or Ig. The most common paraprotein is IgG. If the patient is producing an IgG paraprotein, then the type of multiple myeloma is called the IgG subtype.
Staging of multiple myeloma is based on two widely accepted staging systems. The two systems are the Durie-Salmon Staging System, which is an older staging system, and the International Staging System (ISS). The ISS is more widely used now as it provides better information on the projected survival rate and a more useful guide for the treatment and decision-making process. Without going into the complicated technical details, just take it that both systems adopt the 3-stage grading scale, namely stage 1, stage 2 and stage 3.
Factors That Determine Treatment Of Multiple Myeloma
The type of treatment for the multiple myeloma patient will very much depend on the following factors:
- The type of multiple myeloma
- The extent and stage of multiple myeloma
- Presence of any related complications such as renal failure or bone fracture
- Is this a new disease or a relapse of multiple myeloma
- Health status of the patient, including presence of any coexisting medical conditions
- Lifestyle and quality of life issues of the patient
- Fitness of the patient to undergo stem cell transplantation should there be a need
- Age of the patient
Treatment Of Multiple Myeloma
Treatments are usually focused on therapies that can reduce discomfort and manage complications associated with the multiple myeloma disease. Multiple myeloma is generally thought to be incurable but highly treatable. A combination of the following treatment regime is available, depending on the factors mentioned above:
- Pain killers, antibiotics, steroids, and immunomodulatory drugs
- Red blood cell transfusion or erythropoietin for management of anemia
- Medication to lower blood calcium level and strengthen bone structure with administration of bisphosphonates
- Stem cell transplant
- Chemotherapy and radiation treatments
- Medication to reduce the severity of nerve damage
Relapse Of The Disaese
Any type of cancer is just frightening. However, certain types of cancer have a higher survival rate than others. From my layman's experience, I come across more surviving patients of breast cancer than any other types of cancer.
As for multiple myeloma, there is a likely incidence of relapse following treatments. However, more multiple myeloma patients are able to survive longer because of stem cell transplant and new improved drugs like bortezomib, lenalidomide and pomalidomide. Let us hope that more progress will come through, in the near future to help those suffering from multiple myeloma.to live longer or even get cured.
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Multiple Myeloma-Mayo Clinic
© 2014 Justin Choo