Multiple Myeloma

Cancer of plasma cells

Multiple myeloma is a cancer of plasma cells, which are blood cells that help the body fight infections. These plasma cells are in the soft tissue inside your bones, called the bone marrow. Plasma cells are responsible for making proteins called immunoglobulins. These proteins can be made in excess when myeloma develops.

When plasma cells become cancerous, they grow out of control, create too much protein, and can cause tumors in the bone marrow. Since this can happen in several places, it is called multiple myeloma. The disease can also cause “CRAB” features – high calcium levels, renal/kidney disease, anemia (low red blood cell counts), and bone disease.

Multiple myeloma remains a rare type of cancer that typically affects people over the age of 65. It is also twice as common among African Americans compared to Caucasians.

There is a precursor state called MGUS (monoclonal gammopathy of undetermined significance) that can develop into multiple myeloma over time. Penn State Cancer Institute offers a separate MGUS Clinic for patients to monitor their condition closely and ensure they do not progress to multiple myeloma.

Treatment

Multiple myeloma still cannot be cured, but it has become a cancer that many patients will live with for many years.

For patients with smoldering multiple myeloma, meaning they have not yet developed any symptoms, treatment may not be necessary. These patients can be monitored closely by their doctor.

For patients with active myeloma with indications for treatment, standard treatment options include:

Chemotherapy and other drugs
Radiation
Bone marrow transplant (also called stem cell transplant)
Bone-directed therapy (to help the bones stay strong)
Plasmapheresis (to remove the myeloma protein from the blood)

There are many drugs available for patients with multiple myeloma. Many are now administered by mouth, through subcutaneous (under the skin) injections, and intravenously (IV). Drugs are usually administered in combinations depending on the number of drugs chosen (doublets for 2 drugs, triplets for 3 drugs).

Bone marrow transplants (using a patient’s own bone marrow stem cells – “autologous”) are commonly performed for patients with multiple myeloma. This allows the patient to receive high-dose chemotherapy to get rid of any remaining myeloma in the bone marrow. A patient’s own healthy bone marrow stem cells are then infused back into the patient to replace the bone marrow that was destroyed by the chemotherapy. Here at Penn State Cancer Institute, we perform this type of bone marrow transplant in both the outpatient and inpatient settings, adding convenience for patients who qualify.

Symptoms and Diagnosis

Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells.