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Overview
Multiple myeloma is a cancer that develops in a type of cell called a plasma cell. A plasma cell is a type of white blood cell that grows in the bone marrow, and is part of the body's immune system.
Normal plasma cells make antibodies that help fight infection. However, when they become malignant (turn into cancer cells), they no longer produce antibodies the way they should, and, as a result, the body’s ability to fight infection is compromised. As the myeloma cells grow in the bone marrow they typically overcome the normal plasma cells, as well as other normal white cells, red cells and platelets.
Multiple myeloma can also affect many other sites and organs in the body, including bones, kidneys and nerves.
Symptoms
The symptoms of multiple myeloma generally develop from the organs affected by the disease and can include:
- Bone pain and skeletal fractures
- Frequent infections
- Anemia, causing fatigue, weight loss, and discomfort
- High calcium levels, resulting in nausea, vomiting, depression, headache, and in severe cases, coma
- Loss of kidney function, causing fatigue, a buildup of fluid in the lower limbs, and excessive thirst
- High levels of protein in the blood, causing blood to thicken, which can result in bruising, nosebleeds, headache, dizziness, and peripheral neuropathy (numbness, tingling, and burning pain in the extremities)
In some patients, multiple myeloma is detected, before symptoms appear, through routine blood tests that pick up elevated levels of antibodies present in the blood and produced by the myeloma cells.
Diagnosis
Blood, urine, bone marrow, and imaging tests are used to diagnose multiple myeloma. With these tests, a doctor can determine if a patient has the disease, and the stage and extent of that disease.
Blood and urine tests indicate whether there are excessive amounts of proteins in the blood and/or urine. Blood tests also measure red and white blood cell and platelet counts, the level of kidney function, and can reveal other factors that indicate the extent of the disease.
A biopsy of the bone marrow, showing that it contains more than ten percent plasma cells, suggests that a person might have multiple myeloma. Chromosome tests on bone marrow can determine if the plasma cells of a myeloma patient contain one of several specific abnormalities. These results may be used to give information about the prognosis of someone diagnosed with myeloma.
X-rays, MRI (Magnetic Resonance Imaging), and PET (Positron Emission Tomography) scans are used to determine the number, size, and sites of bone and soft-tissue disease, but are not required in every case for diagnosis of the disease.
Determining Treatment Options
There are currently no treatments that are known to cure multiple myeloma. There are, however, treatments that may slow the progression and alleviate symptoms of the disease. In order to determine the best treatment option and predict the course of the disease for the patients, it is important to determine how much the cancer has spread (metastasized) through a process called "staging." Staging is typically based on 4 different factors for patients with multiple myeloma:
(1) The amount of abnormal monoclonal immunoglobulin in the patient's blood or urine
(2) The amount of calcium in the patient's blood
(3) The severity of bone damage based on x-ray imaging
(4) The amount of hemoglobin in the patient's blood.
Treatments
Treatment options are available for patients with multiple myeloma. These include:
- Immunomodulators—drugs that change the immune system and the environment in which the myeloma cells live to help the body eliminate them.
- Corticosteroids—hormonal medicines like prednisone that may halt the growth of myeloma cells.
- Chemotherapy—uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
- Radiation therapy—uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
- Stem cell transplantation—giving high doses of chemotherapy to treat the myeloma, followed by the infusion (injection in a vein) of stem cells (taken either from the patient or from another person) to rebuild the immune system and blood.
Biogen Idec Investigational Treatments
- Clinical trials—using investigational treatments may be discussed as a possible treatment option for some patients, depending on the specific requirements of the different trials and the patient’s cancer stage and disease status. Click here to learn more about clinical trials. About Clinical Trials
Currently, Biogen Idec is conducting clinical trials in this disease.
For more information, click here. To contact Biogen, click here.
Multiple Myeloma Resources
http://www.multiplemyeloma.org/about_myeloma/2.04.php
http://www.mayoclinic.com/health/multiple-myeloma/DS00415
http://www.centerwatch.com/patient/studies/cat212.html
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