This comprehensive overview explains important aspects of multiple myeloma, including its stages, causes, diagnosis, and treatment considerations. Understanding these factors can help patients and healthcare professionals make informed decisions about managing this blood cancer effectively. The article highlights that early detection and tailored treatment are crucial for improving prognosis, with specific focus on disease progression and diagnostic methods.

Key Factors to Consider Before Starting Multiple Myeloma Treatment

Multiple myeloma is a type of blood cancer that begins in plasma cells within the bone marrow. These cells are essential for producing antibodies to fight infections. When cancer develops, healthy blood cells are crowded out, causing various health complications. Although a cure has not yet been discovered, treatments focus on managing symptoms and improving life quality. The disease's stage plays a vital role in determining the treatment plan, with different approaches depending on how advanced the disease is.

Understanding the stages of multiple myeloma
The progression of multiple myeloma typically occurs in distinct stages :

Stage I:
In these initial stages, only a small portion of the plasma cells are malignant. This can be measured through plasma cell index. Hemoglobin levels are slightly decreased, and minor bone damage may be visible on X-rays, often accompanied by low calcium levels. Blood and urine tests may show abnormal proteins and antibodies.

Stage II:
This intermediate phase features an increase in malignant plasma cells. The clinical features are a mix of those seen in Stages I and III.

Stage III:
The advanced stage involves rapid cancer cell growth, significant hemoglobin reduction, and bone destruction, which releases calcium into the bloodstream, raising calcium levels. Elevated levels of abnormal antibody proteins are seen in blood and urine. Treatments like immunomodulators such as pomalyst are common. This stage often involves metastasis, spreading the cancer to lymph nodes and other tissues.

Are all multiple myeloma stages deadly?

Early stages generally have more treatment options due to limited spread and better outlook, resulting in higher survival chances in Stage I.

As the disease progresses, it impacts larger areas, destroys immune defenses, and reduces survival rates.

Stage III is often considered terminal, usually with disease recurrence, with limited treatment options available and increased mortality risk.

Causes of multiple myeloma

Genetic mutations and abnormalities in bone marrow plasma cells are common causes of excessive growth.

The hormone interleukin-6, released by bone marrow dendritic cells, can overstimulate plasma cell activity, leading to myeloma.

Mutations in oncogenes such as Myc may also contribute to early tumor formation in plasma cells.

The absence of chromosome 17 is a notable marker, often associated with more aggressive and resistant disease.

How is multiple myeloma diagnosed?

Blood tests: Complete blood count (CBC) helps evaluate red and white blood cells and platelets. Elevated plasma cell levels can cause reduced counts overall.

Blood chemistry: Tests assess kidney health (creatinine), calcium (often high in advanced stages), and albumin levels, which tend to decrease with disease progression.

Immunoglobulin measurements: Quantifying antibodies like IgA, IgD, IgE, IgG, and IgM helps identify abnormal antibody production linked to myeloma.