What is Myeloma?

Question 1

What is myeloma?

Answer 1

Myeloma is a type of blood cancer that develops from abnormal (cancerous) plasma cells (these are called myeloma cells)

Myeloma cells may be found in the bone marrow of different bones around the body (called multiple myeloma)

The myeloma cells fill up the bone marrow which makes it harder for the bone marrow to make enough other normal blood cells. Myeloma cells usually make an abnormal immunoglobulin.

Question 2

Abnormal immunoglobulins are sometimes called what?

Answer 2

Paraprotein, or M protein.

Question 3

How are the different types of myeloma names?

Answer 3

Each type of myeloma is named after the abnormal immunoglobulin (paraprotein) the myeloma cells make.

Question 4

What are the symptoms of myeloma?

Answer 4

Myeloma may not cause any symptoms in its early stages. It may be diagnosed after a routine blood test, before any symptoms are noticed

Symptoms include:
- constant bone pain in 1 area (such as in the back, ribs, hip or pelvis)
- an increase in the risk of infection or having infections, one after another, that need antibiotics to treat them
- becoming anaemic and bruising and bleeding more easily – anaemia is when the number of red blood cells in your blood is low
- feeling extremely tired (fatigue)
- tingling or numbness in the hands or feet, though this is rare.

Myeloma may also cause symptoms because it has caused damage to the bones. This can include bone thinning and sometimes fractures. Bone damage can also cause hypercalcaemia.

Myeloma can also cause symptoms if the kidneys are affected. These include feeling tired or confused and having problems peeing.

Question 5

What causes myeloma?

Answer 5

Doctors do not know what causes myeloma.

Having first had the condition MGUS (monoclonal gammopathy of unknown significance) increases risk of developing myeloma.

It is also more common in people over the age of 65.

Question 6

How is myeloma diagnosed?

Answer 6

• Based on symptoms (bone pain, recurrent infections)
• FBCs
• U+Es (check for Bence Jones protein and renal function)
• Bone marrow biopsy
• If myeloma cells are found, further tests called cytogenetic tests, may be done on bone marrow sample (Cytogenetic tests e.g. FISH test - fluorescence in situ hybridisation - look for changes in the chromosomes of the myeloma cells to find out more about the cells and how they might respond to treatment)
• Bone scans (CT, MRI, PET-CT scans)

Question 7

What are the different stages of myeloma? Does it affect treatment?

Answer 7

Myeloma is usually staged from stage 1 to 3.

The stage of the myeloma does not usually affect the treatment offered so doctors do not always talk about staging.

Question 8

How is myeloma treated?

Answer 8

If the myeloma is asymptomatic/smouldering:
- Do not usually need treatment straight away. Instead active monitoring (regular check-ups and tests)

If the myeloma active/symptomatic
- Less intensive treatments )targeted therapies, chemotherapy, steroids, managing symptoms)

Usually, a combination of these treatments is used.

Question 9

Is myeloma usually cured?

Answer 9

Treatment for myeloma is usually very effective and most people have a good response to treatment.

After a time, however, myeloma usually comes back and needs further treatment (relapsed myeloma)