Multiple Myeloma Signs and Symptoms

Multiple myeloma is a cancer of your plasma cells, a type of white blood cell present in your bone marrow. Plasma cells normally make proteins called antibodies to help you fight infections.

In multiple myeloma, a group of abnormal plasma cells (myeloma cells) multiplies, raising the number of plasma cells to a higher than normal level. Since these cells normally make proteins, the level of abnormal proteins in your blood also may go up. Health problems caused by multiple myeloma can affect your bones, immune system, kidneys and red blood cell count.

If you have multiple myeloma but don't have symptoms, your doctors may just monitor your condition. If you're experiencing symptoms, a number of treatments are available to help control multiple myeloma.

Signs and symptoms of multiple myeloma can vary from person to person. Although the condition may not cause symptoms early in the disease, it's likely that you'll experience one or more of the following as the disease progresses:

    - Bone pain, particularly in your back, pelvis, ribs and skull.

    - Presence of abnormal proteins — which can be produced by myeloma cells — in your blood or urine. These proteins — which are antibodies or parts of antibodies — are called monoclonal, or M, proteins. Often discovered during a routine exam, monoclonal proteins may indicate multiple myeloma, but also can indicate other conditions.

    - High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood.

If you have a high calcium level in your blood, you may experience signs and symptoms such as:

    - Excessive thirst and urination

    - Constipation

    - Nausea

    - Loss of appetite

    - Mental confusion

Other signs and symptoms of multiple myeloma may include:

    - Anemia-related fatigue as myeloma cells replace oxygen-carrying red blood cells in your bone marrow

    - Unexplained bone fractures

    - Repeated infections — such as pneumonia, sinusitis, bladder or kidney infections, skin infections, and shingles

    - Weight loss

    - Weakness or numbness in your legs

Although the exact cause isn't known, doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow — the soft, blood-producing tissue that fills in the center of most of your bones. This abnormal cell then starts to multiply.

Because abnormal cells don't mature and then die as normal cells do, they accumulate, eventually overwhelming the production of healthy cells. In healthy bone marrow, less than 5 percent of the cells are plasma cells. But in people with multiple myeloma, more than 10 percent of the cells may be plasma cells.

Because myeloma cells may circulate in low numbers in your blood, they can populate bone marrow in other parts of your body, even far from where they began. That's why the disease is called multiple myeloma. Uncontrolled plasma cell growth can damage bones and surrounding tissue. It can also interfere with your immune system's ability to fight infections by inhibiting your body's production of normal antibodies.

Researchers investigating cause

Researchers are studying the DNA of plasma cells to try to understand what changes occur that cause these cells to become cancer cells. Though they haven't yet discovered the cause of these changes, they have found that almost all people with multiple myeloma have genetic abnormalities in their plasma cells that probably contributed to the cancer. For example, many myeloma cells are missing all or part of one chromosome — chromosome 13. Cells with a missing or defective chromosome 13 tend to be more aggressive and harder to treat than are cells with a normal chromosome 13.

A connection with MGUS

Multiple myeloma almost always starts out as a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS). In the United States, about 3 percent of people over the age of 50 have MGUS. Each year, about 1 percent of people with MGUS develop multiple myeloma or a related cancer. This condition, like multiple myeloma, is marked by the presence of M proteins — produced by abnormal plasma cells — in your blood. However, in MGUS, no damage to the body occurs.Medifocus Guidebook on: Multiple Myeloma
Source : www.mayoclinic.com