Multiple myeloma is the second most common blood cancer among adults in the U.S. It forms part of a group of blood disorders that originate from an abnormal type of white blood cell called plasma cell.

Plasma cells are found in the bone marrow, which is where our body makes blood. They help your body stay healthy by producing proteins called antibodies. These proteins help fight infections by identifying bacteria or viruses and signaling your body to destroy them. With multiple myeloma, plasma cells that don’t work properly grow out of control and can take over the bone marrow space.

The protein made by these abnormal cells does not have the ability to fight infections and the uncontrolled growth of these cells can lead to bone lesions, pain, and bone fractures. The space they take up in the bone marrow can make it hard for healthy blood cells such as platelets, white blood cells, and red blood cells to grow.

The cause of multiple myeloma is poorly understood. Past treatment with radiation therapy, significant exposure to pesticides, or solvents used in furniture factories can increase the risk for this type of cancer. 

Multiple Myeloma Symptoms

Multiple myeloma most commonly causes:

  • Low red blood cell count (anemia), which can lead to fatigue and shortness of breath
  • Low amount of functional antibodies, which makes you more likely to get infections
  • Low platelet count, which can lead to abnormal bleeding
  • Signs of kidney damage that can be identified with blood tests
  • Bone pain, weak bones, and a higher risk of broken bones (bone fractures)
  • In some cases, confusion or sleepiness caused by high calcium levels

Multiple Myeloma Diagnosis

Routine check-ups with blood tests done by your primary care can detect abnormal levels of the proteins produced by the abnormal plasma cells, also called myeloma cells. These blood tests can also identify signs of kidney damage, low red blood cells (anemia), or high levels of calcium that could suggest multiple myeloma. Sometimes imaging studies like x-rays or CT scans of the bones may show lesions.

If your doctor suspects this type of cancer, additional blood and urine tests may be performed. A bone marrow biopsy or additional imaging studies to look for bone lesions or tumors will be done by a cancer doctor.

In a few cases, some tests may be needed to look for variants or this disease such as amyloidosis, plasma cell leukemia or POEMS.

Multiple Myeloma Treatment Options

At Wake Forest Baptist, a team of cancer specialists will work together with you to provide the most advanced personalized treatment available.

Because of our multidisciplinary approach to treatment for all cancers, Wake Forest Baptist has been designated by the National Cancer Institute as a Comprehensive Cancer Center, one of only 51 in the country.

Treatment can include one or more of the following:

  • A combination of chemotherapy drugs to make a regimen that will provide optimal control and destruction of cancer cells. 
  • Radiation therapy to relieve bone pain or to shrink a tumor that could be affecting a vital organ of the body.
  • A stem cell transplant to help get a deeper response to treatment and maintain remission for a longer period of time. 

Two types of transplant are available:

  • Autologous stem cell transplantation is performed using a person's own stem cells.
  • Allogeneic transplant uses someone else's stem cells. This treatment has serious risks, but may offer the chance of a cure in special cases.
  • Therapy to strengthen bones and help prevent fractures with a type of medicine called bisphosphonates. These can help kill cancer cells when combined with chemotherapy.
  • Clinical trials that give access to new treatments that may benefit patients with myeloma.  These may include immune therapy, CAR-T therapy, BiTE therapy, vaccines, or new chemotherapy agents.