Multiple Myeloma

Introduction

Multiple myeloma is a malignancy that develops in a type of white blood cell known as a plasma cell. Healthy plasma cells help fight infections by producing antibodies. Antibodies detect and attack pathogens. In multiple myeloma, malignant plasma cells accumulate in the bone marrow. The bone marrow is the soft tissue found inside bones that produces blood cells. Cancer cells compete with healthy blood cells in the bone marrow. Instead of producing beneficial antibodies, cancer cells produce proteins that do not function normally. This causes issues in multiple myeloma.

Symptoms

Early in multiple myeloma, there may be no symptoms. When signs and symptoms appear, they may include bone pain, particularly in the spine, chest, or hips; nausea; constipation; lack of appetite; mental fogginess or disorientation; exhaustion; weight loss; weakness; thirst; and the need to urinate frequently.

Causes

It's unclear what causes myeloma. Multiple myeloma starts with a single plasma cell in the bone marrow. The bone marrow is the soft tissue found inside bones that produces blood cells. Something happens to convert the plasma cell into a malignant myeloma cell. Myeloma cells rapidly multiply. Healthy cells develop at a consistent rate and die at a predictable time. Cancer cells do not obey these guidelines. They produce a lot of additional cells. When healthy cells would perish, they would continue to live. In myeloma, cancer cells accumulate in the bone marrow, crowding out healthy blood cells. This causes fatigue and an inability to fight infections.

Diagnosis

A healthcare practitioner may discover multiple myeloma while performing a blood test for another disease. Other times, your symptoms may prompt your doctor to test for multiple myeloma. Multiple myeloma can be diagnosed using blood testing, urine tests, bone marrow tests, and imaging studies.

Treatment

Multiple myeloma treatment isn't always needed right away. If there are no symptoms, you might have tests to watch the myeloma to see if it gets worse. When multiple myeloma causes symptoms, treatment often starts with medicine. Treatment can help relieve pain, control complications, and slow the growth of the myeloma cells.

Treatments may include:

• Targeted therapy: Therapy with a specific goal in mind. Targeted therapy employs medications that target specific molecules in cancer cells. Targeted medicines that block these molecules can kill cancer cells.

• Immunotherapy: Immunotherapy is a drug-based treatment that stimulates the immune system to attack cancer cells. The immune system fights disease by fighting bacteria and other abnormal cells in the body. Cancer cells live by evading the immune system. Immunotherapy aids the immune system cells in locating and killing cancer cells.

• CAR-T cell therapy: Chimeric antigen receptors T cell treatment, also known as CAR-T cell therapy, prepares your immune system cells to combat multiple myeloma. This treatment starts by removing some white blood cells, especially T cells, from your blood. The cells are transferred to a laboratory. In the lab, cells are treated to produce specific receptors. The receptors aid cells in recognizing a marker on the surface of myeloma cells.

The cells are then reintroduced to the body. Multiple myeloma cells can now be identified and eradicated with chemotherapy, corticosteroids, and bone marrow transplants. Before a bone marrow transplant, blood-forming stem cells are harvested from your blood. To remove the damaged bone marrow, high doses of chemotherapy are used. The stem cells are then transplanted into your body. They travel to the bones and begin rebuilding the marrow. An autologous bone marrow transplant uses your cells.

How treatments are used

If you are likely to require a bone marrow transplant, your treatment strategy will be determined accordingly. Your healthcare team analyses a variety of variables when determining if a bone marrow transplant is the best option for you. These include the likelihood that your multiple myeloma may worsen, your age, and your overall health. If your healthcare provider believes a bone marrow transplant is a good option for you, treatment usually begins with a combination of medications. The combination could include targeted therapy, immunotherapy, corticosteroids, and, in some cases, chemotherapy. After a few months of treatment, your blood stem cells are extracted. If a bone marrow transplant is possible, it could take place soon after the cells are collected. Doctors may recommend two bone marrow transplants for persons who have multiple myeloma.

Treating complications

Treatment may include managing the consequences of multiple myeloma. Examples include bone pain, kidney damage, infections, bone loss, and anemia.

Conclusion

Multiple myeloma is a difficult hematological cancer characterized by the uncontrolled proliferation of plasma cells in the bone marrow. While there is no cure at this time, advances in treatment tactics have dramatically improved many patients' prognoses and quality of life.