Multiple
myeloma
HADEEL HAMEDA
2 2 11 0 4 4 9
ONCOLOGY
What is Multiple Myeloma?
Symptoms of Multiple Myeloma
Pathophysiology
Diagnosis and Staging
Treatment Options
Living with Multiple Myeloma
Research and Future Directions
What is Multiple Myeloma?
• Multiple Myeloma is a type of cancer that affects plasma cells, which are a type of white blood
cell. These cells are responsible for producing antibodies that help fight infections and diseases.
When someone has Multiple Myeloma, their plasma cells become abnormal and grow out of
control, forming tumors in the bone marrow and other parts of the body.
Symptoms of Multiple Myeloma
• Multiple Myeloma is a type of cancer that affects the plasma cells in the bone marrow. The most
common symptoms include bone pain, fatigue, and weakness. Other symptoms may include
anemia, infections, and kidney problems. These symptoms can have a significant impact on a
person's quality of life, making it important to seek medical attention if they persist.
• not everyone with Multiple Myeloma will experience all these symptoms, and some people may
not experience any symptoms at all. This makes regular check-ups and monitoring essential for
early detection and treatment.
Pathophysiology
• The development of MM is commonly preceded by MGUS, a premalignant condition that results
when plasma cells undergo mutations that restore their capacity for proliferation.
• A variety of cytogenetic abnormalities are found in MGUS and MM. Approximately half of cases
are hyperdiploid, usually with extra copies of the odd-numbered chromosomes.
Pathophysiology Cont.
• Increasing evidence suggests that the bone marrow microenvironment of tumor cells plays a
pivotal role in the pathogenesis of myelomas. [8] This discovery has resulted in the expansion of
treatment options
• The pathophysiologic basis for the clinical sequelae of MM involves the skeletal, hematologic,
renal, and nervous systems, as well as general processes.
Diagnosis of Multiple Myeloma
Multiple Myeloma is typically diagnosed through a combination of tests and procedures. These may include:
- blood and urine tests
- M protein.
- bone marrow biopsies.
- imaging scans such as X-rays or MRIs.
- Immunoglobulin.
- Light chains.
.
- Serum albumin and serum beta-2 macroglobulin (β2-M).
- Lactase dehydrogenase (LDH).
The goal of these tests is to identify the presence of abnormal plasma cells, which are characteristic of
Multiple Myeloma.
Staging of Multiple Myeloma
Once a diagnosis has been made, the disease is staged based on various factors such as the extent
of bone damage, the level of certain proteins in the blood, and the number of abnormal plasma
cells present. This staging helps doctors determine the best course of treatment for each patient.
Staging Cont.
Stage I: All of the following apply:
- β2-M less than 3.5 mg/L
- Serum albumin of 3.5 g/dL or more
- Normal LDH
- No high-risk chromosome changes in myeloma cells found by FISH test
Stage II: Not stage I or stage III.
Stage III: β2-M is more than 5.5 mg/L, plus one of the following:
- Myeloma cells have high-risk chromosome changes found by FISH test
- High LDH
Treatment Options.
Multiple Myeloma is a complex disease that requires a multi-pronged approach to treatment.
There are several different options available, each with its own set of pros and cons.
Chemotherapy is one of the most common treatments for Multiple Myeloma. It involves the use
of drugs to kill cancer cells, but it can also damage healthy cells in the process. Radiation therapy
is another option, which uses high-energy radiation to kill cancer cells. While effective, it can also
cause side effects like fatigue and nausea.
Treatment Options Cont.
Stem cell transplant is a more aggressive treatment option, which involves replacing damaged
bone marrow with healthy stem cells. Finally, targeted therapy uses drugs to target specific
proteins or pathways that are involved in the growth of cancer cells. This approach can be highly
effective, but it may not work for everyone.
Living with Multiple Myeloma.
Living with Multiple Myeloma can be challenging, but there are many things you can do to
manage your symptoms and improve your quality of life. It's important to work closely with your
healthcare team to develop a personalized treatment plan that addresses your individual needs and
goals.
One of the most important things you can do is to take an active role in your own care. This
means staying informed about your condition, keeping track of your symptoms and side effects,
and communicating openly and honestly with your healthcare providers
Research and Future Directions
Recent studies have shown promising results in the use of immunotherapy, which harnesses the
power of the immune system to target cancer cells. This approach has been found to be effective
in treating other types of cancer and may hold great promise for Multiple Myeloma patients in the
future.
Another area of research focuses on developing more personalized treatment plans based on a
patient's unique genetic profile. By analyzing a patient's DNA, doctors may be able to identify
specific mutations that are driving the growth of cancer cells and develop targeted therapies to
address those mutations.