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Multiple myeloma (also known as myeloma or plasma cell myeloma) is
a hematologic cancer, meaning it develops in the blood. It is a cancer
of the plasma cell, an important part of the immune system that
produces immunoglobulins (antibodies) to help fight infection and
Incidence of multiple myeloma
There are approximately 45,000 people in the United States living
with multiple myeloma, and the American Cancer Society estimates that
approximately 14,600 new cases of myeloma are diagnosed each year in
the United States.
Multiple myeloma is the second most prevalent blood cancer (10%)
after non-Hodgkin's lymphoma. It represents approximately 1% of all
cancers and 2% of all cancer deaths. Although the peak age of onset of
multiple myeloma is 65 to 70 years of age, recent statistics indicate
both increasing incidence and earlier age of onset.
Multiple myeloma affects slightly more men than women. African
Americans and Native Pacific Islanders have the highest reported
incidence of this disease and Asians the lowest. Results of a recent
study found the incidence of myeloma to be 9.5 cases per 100,000
African Americans and 4.1 cases per 100,000 Caucasian Americans. Among
African Americans, myeloma is one of the top 10 leading causes of
Symptoms and diagnosis of multiple myeloma
Symptoms can include: malaise, anemia, infections (decreased
immunity) and fractures (due do breakdown of bone by malignant cells).
Often, the diagnosis of multiple myeloma is often made incidentally
during routine blood tests for other conditions.
The existence of unexplained anemia and a high serum protein
(especially raised globulin) may suggest further testing. A doctor
will then order protein electrophoresis, on which a paraprotein band
can be noticed. Quantitative measurements of the paraprotein are
necessary to determine the seriousness of the disease.
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Pathology of multiple myeloma
There are at least two forms of myeloma:
- Secretory - where enzymes are released that allow blood testing
for diagnosis and progression monitoring.
- Non-secretory - where enzymes are not released and are thus not
available for blood testing. Progression in these cases in monitored
through bone marrow byopsies and looking for elevated levels of bone
marrow plasma cells.
Treatment of multiple myeloma
Treatment for multiple myeloma is focused on disease containment
and suppression, as no reliable cure has been found.
Modes of therapy include:
- Thalidomide with steroids.
- Low-dose chemotherapy with melphalan
- Chemotherapy with vincristine, adriamycin and dexamethasone
- High-dose chemotherapy (melphalan) with stem cell transplant.