Multiple Myeloma – Bone Marrow Cells Taking Over

Danger level: High

What is it?

Multiple myeloma is a blood cancer involving cells called plasma cells, in the bone marrow.

Who gets it?

In the US, 4 out of 100,000 people are found to have it each year. It’s a little more common in men than women, and almost twice as common in African American than in white people.

It’s usually found around the ages 65-70.

What causes it?

The bone marrow is the place within our bones where blood is produced. All types of blood cells (red blood cells, white blood cells and platelets) are produced there. 

One of the types of white blood cells (cells that are usually responsible for fighting infections) is plasma cells. They are responsible for producing antibodies – molecules that fight infections. In multiple myeloma, plasma cells divide in an uncontrolled manner and take over the bone marrow. They mass together and create tumors in different areas of the body, especially the bone marrow.

multiple-myeloma

The bone marrow in multiple myeloma – Every purple round cell here is a plasma cell. They’ve taken over the bone marrow in this picture.

How does it feel?

Multiple myeloma can cause any of the following things:

  1. Bone problems – The tumors of plasma cells in the bone can cause pain, usually in the back or chest, but it can also happen in the arms or legs. The other thing that happens to bone here is bone loss, which can lead to fractures. If these fractures happen in the spine, it can also cause neurologic problems.
  2. High blood calcium levels – Bone here is lost. But the lost bone doesn’t just disappear. Bone contains calcium (among other things). When the bone is lost here, the calcium in it is released to the blood, which in high levels can cause loss of appetite, nausea, vomiting, constipation, thirst, weakness, confusion and even coma.
  3. Anemia – Since more white cells are produced here, less red cells are produced – causing anemia and weakness (the red cells are responsible for delivering oxygen to our body).
  4. Kidney problems – There are many reasons for this, such as the high levels of a

    ntibodies the many plasma cells here produce, and also the high calcium level in the blood. This causes the kidneys to fail.

  5. Thickened blood – The many antibodies created here cause the blood to be thick, which causes flow problems, leading to bleeding from the mouth or nose, blurred vision, heart failure and neurologic problems.
  6. More infections – We said that more plasma cells (which fight infections) are created here. But they are defective, and are created on the account of normal cells – this causes problems with fighting infections.

To better understand all of these complex symptoms you can watch this movie, which tells the story of 3 patients who found out they have multiple myeloma:

How is it discovered?

There are a few tests that can be done:

  1. Blood tests and urine tests – They can find the high level of antibodies created by the plasma cells.
  2. Bone marrow examination – This is done by a biopsy (cutting a piece of bone) or aspiration (“sucking” bone marrow with a needle). A picture similar to the one above will show. It takes an excess of more than 10% of plasma cells to prove that there is multiple myeloma.
  3. X-rays: The bone destruction here causes “holes” in the bone, which are called “lytic lesions”. They will show on x-ray.

How is it treated?

There are several things that can be done to treat it:

  1. Chemotherapy – It doesn’t cure the disease,but controls it.
  2. Bone marrow transplantation – From the patient’s own body (the usual treatment) or from a donor.
  3. Other types of drugs

What happens after treatment?

The disease tends to recur, and should be treated again. The survival in the disease can change according to many criteria, but it can go between years to months.


The bottom line: How do I avoid it?

Unfortunately, there is no known way to prevent it. If you do feel any of the symptoms described above and you’re the right age, seeking medical help early might be the best course of action.

 

Have you encountered the disease yourself, or in someone you know? Share in the comments.

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Posted in Blood
 

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