Medically Reviewed by James C. H. Smith, MD

From an interview with James C. H. Smith, MD McLeod Oncology & Hematology Associates

Multiple myeloma is the second most common form of blood cancer. It occurs when plasma cells in a person’s bone marrow react abnormally. It can even result in DNA changes in your bone marrow. Yet, it can be treated, says McLeod Oncologist James Smith, MD.

Here are highlights from Dr. Smith’s remarks:

Multiple myeloma is a plasma cell abnormality that is produced in the bone marrow. Symptoms related to that process include high calcium and problems with kidney function. Patients can also have abnormality of the bone or bone lesions. As a consequence of the disrupted bone marrow production process we can also see anemia, a risk of infection and problems with platelet production. As a result, the patient has a low platelet count, leading to bleeding problems.

This condition is thought of as a systemic problem but it originates as a disruption in the bone marrow with the plasma cells becoming more predominant.

Multiple myeloma is also more commonly seen in older adults. This would be a rare condition in adolescents or at a younger age. As the population ages, the incidence of multiple myeloma increases.

The disease can also look osteoporotic, because basically it weakens the bones. Patients develop bone lesions which is a sign of weakening of the bones. In X-rays this can look like holes in the bones.

Detecting the condition can include a blood test that identifies an abnormal protein associated with multiple myeloma; characteristic changes on X-rays or MRIs of the bone structure; and a bone marrow biopsy which would show the increase in plasma cells in the bone marrow. There are also specific DNA changes in the bone marrow that drive the process, which can affect the patient’s prognosis.

Treatment of myeloma has dramatically changed over the last few years. We’ve gone from some of the standard chemotherapy agents to more targeted treatments that are specific to the disruption of the myeloma production process. These treatments have fewer side effects than what we saw in chemotherapy from years ago. It’s one of those fields, where from year to year we see significant changes and new treatments evolve. The treatment of myeloma is definitely a dynamic field.

The downside of myeloma is that the treatment generally does not render a cure. It’s more of a maintenance-type therapy, geared at controlling the disease process. These treatments will need to be continued from the time of diagnosis throughout the patient’s life.

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