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Multiple Myeloma

Multiple myeloma, also known as myeloma or plasma cell myeloma, is a hematological cancer, meaning it develops in the blood. Multiple myeloma is the second most common cancer of the blood. About 60,000 people have this disease and 20,000 new cases are diagnosed each year in the United States. The peak age of disease onset is 65 years of age, but recent statistics indicate the disease is becoming more prevalent and that people are getting the disease at younger ages.

In multiple myeloma, the body produces too many plasma or myeloma cells. These cells produce antibodies that the body doesn't need, which can form tumors and cause other problems, such as bone fractures and kidney failure.

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Although the cause of multiple myeloma is unknown, a number of possible associations between myeloma and a decline in the immune system, genetic factors, certain occupations, exposure to certain chemicals and radiation, and a certain virus have been suggested.

Myeloma has always been thought of as fatal, but recent progress has resulted in longer survivals and possibly even some cures. At UCSF, blood disorder specialists offer a variety of treatments for multiple myeloma, including chemotherapy, stem cell transplantation, biologic response, vertebroplasty and radiation therapy.

In addition, patients are encouraged to participate in clinical trials aimed at improving therapy for all people with multiple myeloma. For information on current clinical trials at UCSF, please click here.

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Symptoms of multiple myeloma depend on how advanced the disease has become. In the earliest stages, a person may not have any symptoms.

When symptoms do occur, patients commonly experience:

  • Bone pain (often in the back or ribs)
  • Broken bones
  • Weakness
  • Fatigue
  • Weight loss
  • Repeated infections

When the disease is advanced, symptoms may include:

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The diagnosis of multiple myeloma is often made incidentally during routine blood tests for other conditions. For example, the existence of anemia and a high serum protein may suggest further testing.

A number of laboratory tests and medical procedures are performed to help confirm a diagnosis of multiple myeloma. Many of these tests also are used to assess the extent of the disease as well as to plan and monitor treatment.

  • X-rays — All patients need to have X-rays to see if any bones are damaged or broken.
  • Blood and Urine Tests — Samples of the patient's blood and urine are checked to see whether they contain high levels of antibody proteins, called M proteins.
  • Bone Marrow Aspiration and/or Biopsy — The doctor also will perform these procedures to check for myeloma cells.

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Multiple myeloma is very hard to cure, although allogeneic stem cell transplantation has cured patients with the disease. Unfortunately, however, allogeneic transplantation can only be used in a minority of patients with myeloma due to donor availability and age limitations. The good news, though, is that many current treatments extend overall survival and improve the quality of a patient's life by controlling the symptoms and complications of the disease.

Patients with multiple myeloma who do not experience symptoms may not require treatment. For these patients, the risks and side effects of treatment are likely to outweigh the possible benefits. However, these patients should be watched closely and should begin therapy when symptoms appear.

Patients who require treatment for multiple myeloma usually receive chemotherapy, radiation therapy, stem cell transplantation and/or thalidomide. New drugs used to treat multiple myeloma include Velcade, which has recently been approved for use by the U.S Food and Drug Administration (FDA). Another novel therapy, called Revimid, is currently in the last phase of clinical trials.

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Reviewed by health care specialists at UCSF Medical Center.

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