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Multiple Myeloma

Multiple Myeloma is a type of cancer of the Bone Marrow in which myeloma cells multiply abnormally and start to replace the normal plasma cells. This adversely affects the body’s ability to produce antibodies, provide immunity and also weakens the bones.  The tumour formed by these malignant plasma cells is called Plasmacytoma and the condition in which many such tumours are developed is known as Multiple Myeloma. 

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Symptoms

The signs and symptoms of Multiple Myeloma start to appear at a later stage and include-

  • Fatigue and Weakness
  • Pain in the bones (especially back and ribs)
  • Weight loss
  • Excessive thirst
  • Frequent urination
  • Recurrent infections, Fever
  • Nausea and Constipation
  • Frequent fractures
  • Lumps seen underneath the skin (Extramedullary Plasmocytoma)

Diagnosis

Multiple Myeloma can be diagnosed by regular Blood Tests which will show M proteins and some abnormal globulins that are produced by the Myeloma cells. It may also show an increased level of Calcium in the blood and very few Red Blood Cells (Anaemia). Bone Marrow Aspiration and Biopsy are essential to confirm Multiple Myeloma. Cells of the bone marrow are observed under the microscope to assess abnormalities and the type of Myeloma cells. MRI scan, CT scan and other imaging tests are helpful to see detailed pictures of the bones. Urine tests are also required in order to confirm the type of proteins produced and to assess its effect on the kidney.

Treatment

Multiple Myeloma can be treated in the following ways:

  • Chemotherapy is the treatment involving anticancer drugs which have to be taken according to the stage of the disease. This has side effects on the body such as – Hair loss, Diarrhoea, or sometimes infertility.
  • Radiation Therapy involves killing of cancer cells in a specific location using high energy X-Rays and obstructs the formation of abnormal proteins. 
  • Plasmapheresis is the replacement of abnormal plasma cells present in the blood with normal plasma from donors, with the help of a machine.
  • Stem Cell Transplant / Bone Marrow Transplant is the most effective way to treat Multiple Myeloma. Stem cells of the patient or a donor multiply to form healthy blood cells.

Risks

A Bone Marrow Transplant entails the following risks:

  • Graft-versus-Host disease - donor cells start to attack those of the recipient and hence causes immunity problems
  • Graft rejection - donor stem cells do not function effectively in the recipient and fail to differentiate into blood cells.
  • Thrombocytopenia and anaemia
  • Infections and Bleeding
  • Damage to the liver
  • Delayed growth in children
  • Clotting- in blood vessels 

After Procedure

In case of a bone marrow transplant, the patient is monitored by the doctor for signs of graft rejection. A medication for GVHD is given to prevent it from occurring. Antifungals, antivirals and antibiotics are also given in order to prevent all sorts of infections. Regular blood tests are conducted in order to check if blood counts are back to normal and to check the functioning of the donor’s stem cells in the recipient. The patient may require blood transfusions in case of too much blood loss or slow recovery.     

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