What is myeloma?

Related conditions:

Non-Hodgkin lymphoma, other blood cancers

Definition:

Myeloma is a cancer of the plasma cells found in the bone marrow. Plasma cells produce antibodies, which fight infection. In myeloma, abnormal plasma cells in the bone marrow overproduce monoclonal immunoglobulins. Multiple myeloma occurs when there are multiple bones affected.

Risk factors: As nearly all cases of multiple myeloma are diagnosed in adults over the age of forty, age is considered the most significant risk factor. It is thought, however, that myeloma is the result of several unknown factors working together.

Etiology and the disease process: The definitive cause of myeloma has not been determined. However, as age is its primary risk factor, potential causes include age-related factors such as long-term exposure to carcinogens, toxins, genetic variations, and decreased immune response.

Incidence: Myeloma is most commonly found in African Americans and occurs more frequently in men. Multiple myeloma is the second most common type of blood cancer in the United States (non-Hodgkin lymphoma is the first), according to the National Cancer Institute in 2013. The American Cancer Society estimated that there would be approximately 24,050 new cases diagnosed and about 11,090 deaths from myeloma in 2014 in the United States. The average age of diagnosis is seventy, and very few cases are diagnosed in people under the age of forty, according to the American Society of Clinical Oncology as of 2014.

Symptoms: A common symptom is back pain, often accompanied by bone pain of the pelvis, ribs, and neck. Patients with myeloma have also reported excessive fatigue, iron deficiency, decreased immunity (frequent colds or sickness), a decrease in appetite, constipation, “pins and needles” in the feet and legs, and abnormal bleeding of the nose or gums.

Screening and diagnosis: There is no standard screening for myeloma; however, patients considered at risk and exhibiting symptoms should see a hematologist (a doctor who specializes in blood disorders) and have a series of tests performed to determine a diagnosis. Blood tests, urinalysis, X rays, bone scans, and bone marrow biopsy are typically performed.

There are two systems for staging myeloma: the Durie-Salmon Staging System and the International Staging System.

Treatment and therapy: Treatment for myeloma, like that for most cancers, depends on the stage of disease. Patients are often treated with chemotherapy and radiation, as well as additional therapies to target plasma cells.

Prognosis, prevention, and outcomes: Prognosis for myeloma depends on the stage at which the patient is diagnosed and the patient’s overall health. While myeloma is not curable, it can be treated and managed. Most patients survive for at least one year following diagnosis, and according to the American Society of Clinical Oncology's 2014 statistics, people diagnosed with myeloma have a five-year survival rate of about 45 percent.

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Gertz, Morie A., and S. Vincent Rajkumar, eds. Multiple Myeloma: Diagnosis and Treatment. New York: Springer, 2014. Print.

Rajkumar, S. Vincent. "Multiple Myeloma: 2012 Update on Diagnosis, Risk-Stratification, and Management." American Journal of Hematology 87.1 (2012): 78–88. Print.

Schey, Stephen A., et al., eds. Myeloma: Pathology, Diagnosis, and Treatment. New York: Cambridge UP, 2014. Print.

Tamkin, Jim, and Dave Visel. The Myeloma Survival Guide: Essential Advice for Patients and Their Loved Ones. New York: Demos Health, 2014. Print.