Multiple myeloma is a type of bone marrow cancer caused by the malignant degeneration of plasma cells. Normal plasma cells are part of the immune system, which is made up of several types of cells that work together to fight infection and other diseases. Lymphocytes are the main cell type of the immune system. The main types of lymphocytes are B cells and T cells.
When B cells respond to an infection, they mature into plasma cells. Plasma cells produce antibodies (also called immunoglobulins) that help the body attack and destroy germs. They are found mainly in the bone marrow. Bone marrow is the soft tissue found inside the cavity of some bones, and its function is to manufacture blood cells (white blood cells, red blood cells and platelets).
When plasma cells become cancerous and grow out of control, they produce large amounts of an abnormal immunoglobulin that can be detected in the blood and/or urine. These excess immunoglobulins interfere with various properties of the blood, the normal functioning of the kidneys, and promote the development of infections (as other immunoglobulins are not produced). In addition, excess plasma cells can damage the bones and displace normal bone marrow cells (hindering the normal production of red blood cells, white blood cells and platelets).
The main symptom is bone pain, which occurs in 75% of patients (mainly in the spine and ribs).
Other possible manifestations are due to a lack of red blood cells (tiredness, weakness, palpitations, dizziness) or altered platelet function (easy bruising, bleeding from the nose or gums). In addition, there may be weight loss, frequent infections and, on occasion, the appearance of true plasma cell tumours (plasmacytomas). Eighty percent of patients present with osteoporosis, osteolysis (when one or more areas of a bone are worn away and shrink), or bone fractures at the time of diagnosis.
Diagnosis is based on the demonstration of an abnormally high amount of a certain type of immunoglobulin in the blood and/or urine and an excess of plasma cells in the bone marrow.
Finally, X-rays of all bones should be performed. Other common abnormalities of this disease found upon analysis include increased creatinine (renal failure) and plasma calcium, anaemia and decreased platelet count.
There is now a consensus that a patient with multiple myeloma should only be treated if any of the following symptoms are present: hypercalcaemia, renal failure, anaemia or bone lesions.
If treatment is required, it will be based on the administration of a combination of chemotherapy drugs, and in patients under 70 years of age, this treatment will be consolidated with an autologous bone marrow transplant (administration of intensive chemotherapy followed by an infusion of the patient’s own blood progenitor cells).
The aim of treatment is always to slow the progression of the disease and improve the symptoms, as, unfortunately, none of them can completely cure the disease. In any case, more than half of the patients manage to have either all symptoms disappear (complete remission) or part of them (partial remission) with analytical alterations that can be kept under control for many months, or even years.
As a complementary measure, bisphosphonates are usually administered, which are agents that inhibit the activity of osteoclasts (the cells responsible for bone destruction) and promote bone recalcification.
The haematology unit offers comprehensive care for patients with haematological malignancies
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a multiple myeloma diagnosis, but there are some recommendations that can help you through this process: