Multiple Myeloma: Symptoms, Signs, and Prognosis

Multiple Myeloma

Multiple Myeloma belongs to the group of cancers that occur within the white blood cells. More specifically, this is a plasma cell cancer. Plasmas cells are white blood cells responsible for acting as precursors to form into the B memory cells, in the immune system. Of all the plasma cell cancers, Multiple Myeloma is the most common one. It is seen mostly in older adults and mainly in men, but women can be diagnosed also. The main physical findings of this type of cancer are numerous holes within the bone. The bones will be susceptible to fractures, and loses its cohesiveness and strength. The general symptom the person will go to their doctor complaining of is pain inside their body.

The person may also have symptoms of renal and intestinal disease with increased urination and constipation. If the brain is affected by increased calcification due to bone breakdown, this can cause neurology symptoms such as disorientation and confusion. With the decrease in bone mass, the person feels more tired and weak, as more bone is broken down.

Since this is a plasma cell cancer, the signs and laboratory findings discovered by the physician can be extensive. The blood will show an increase in the amount of B cell precursors especially with a large amount of plasma cells in the lesions of the bone. There will also be an increase in the amount of M type immunoglobulin antibodies that the plasma cell produces. Holes in the bone can be found in the bones of the skull, but also in the vertebrae and femur. Any bone can show signs of this disease.

People with Multiple Myeloma might also have kidney involvement with a proliferation of proteins being released into the urine. This shows kidney damage and the condition is called Bence-Jones proteinuria. If the condition is severe, then the plasma cells can be transported all over the body. Common places in severe cases would be in the spleen and the lymph nodes where blood is filtered. Other than the lesions in the bone and kidney disease, someone with Multiple Myeloma also can have infections with serious bacteria such as E. coli or Streptococcus pneumoniae. The bone marrow may also be involved with almost all of the red and white blood cells be affected. It is possible to even have thrombocytopenia present.

With multiple myeloma, the prognosis will vary depending on the person’s age and the organs involved. If the lesions of the bone are extensive and located in many areas, this can affect the person’s survival rate. If the kidneys are affected with a large amount of proteins in the urine, then the prognosis might be worse. A high antibody level with the combination of the above can be one of the worse prognosis. Chemotherapy can help send the disease into remission for at least sixty percent of the patients. The survival rate between the time they are diagnosed is approximately three years.

References

Print Source: Davidson, Stanley & C. Haslett. 2002. “Davidson’s Principles and Practice of Medicine.” Churchill Livingstone, Edinburgh.

Web Source: National Cancer Institute. “What You Need To Know About Multiple Myeloma.” 2009. Available: https://www.cancer.gov/cancertopics/wyntk/myeloma/page2