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CancerQuest > Introduction to Patient Information > Introduction to Cancer by Type > Multiple Myeloma: Introduction > Section Summary: Multiple Myeloma

Section Summary: Multiple Myeloma

 Introduction

• Results from malignant B cells that migrate to the bone marrow.
• ACS estimates that 20,180 new cases of MM will be diagnosed and 10,650 deaths will be reported.
• Only accounts for 1% of all cancers
• Current 5-year survival rate is 30%

Anatomy

• B plasma cells are a type of differentiated lymphoid cell
• Plasma cells normally produce antibodies, proteins that help combat various pathogens, each cell produces a specific antibody
• In MM, the cancerous plasma cells become uncontrollable and produce large amounts of a non-helpful antibody.
• The cells migrate to the bone marrow where they recieve growth signals
• Typically the tumor in the bone marrow spreads to other parts of the body.

Risk Factors

• Male to Female ratio of diagnoses is 1.4 : 1
• ACS estimates 11,170 men and 9,010 women will be diagnosed in 2010
• For reasons unknown MM is twice as likely in African Americans as in Caucasians.
• Age, gender, race, radiation exposure, family history, working in oil-related industries, weight, other plasma cell diseases may also increase risk

Symptoms

• Symptoms may not be apparent until a late stage of the disease
• It is important to get routine blood work done
• Symptoms may include: chronic pain in the bone, chronic fatigue, anemia, neuropathy, recurring infections, hypercalcemia.

Detection and Diagnosis

• Blood or Urine tests can detect abnormalities in antibody protein levels
• NCCN recommends CT scans
• Biopsy is an option
• Dental professionals can identify some cases (jaw)

Staging and Pathology

• New staging system called the "International Staging System" is now used.
• The ISS is simpler than previous systems
• Staging is now based on the levels of Beta-2 microoglobulin in the blood of the patient.

Multiple Myeloma Tumor Biology

• MM development is dependent on gene mutation and growth factors.
• The bone marrow provides growth signals to the tumor and prevents cell death.
• Some of the cytokines involved are: IL-6, TNFa, VEGF, IGF-1, SDF-1a, HGF
• Some of the genes involved are: PTTG-1, PI3K, AKT, GILZ

Treatment

• Treatment success is very dependent on the stage of the cancer
• A primary option is Hemopoeitic Stem Cell transplant
• Chemotherapy with bortezomib and doxorubicin is frequently used.