Myeloma is a form of blood cancer that begins with plasma cells in the bone marrow. Even though it is a type of blood cancer, it may affect red cells (anaemia), bone lesion and fractures, kidney impairment/failure and high level of calcium.
INTRODUCTION OF MYELOMA
How Does Myeloma Progress?
When a plasma cell undergoes a mutation, myeloma develops. B lymphocytes, or B cells, are a subset of white blood cells that reside in the bone marrow and are the source of plasma cells. As a component of the immune system, healthy plasma cells produce “antibodies,” which are proteins that aid in the battle against infection.
The myeloma cell, a mutant kind of plasma cell, spreads and will continue to grow in the bone marrow if left untreated. In the bone marrow, they displace the normal stem cells and healthy plasma cells that produce platelets, red blood cells, and white blood cells. If the malignant cells are not treated, they may:
- If healthy white blood cells are overpopulated, the immune system is unable to properly fight infection.
- Release a lot of protein into the urine and blood, which might harm the kidneys.
- Build up in the bone weakens it and can result in fractures and bone pain.
Signs and symptoms
- Kidney issues
- Loss of weight
- Unusual blood counts.
- Feeling queasy, disoriented, or unwell
- Exhaustion, breathlessness, or a pounding heart
- Elevated amounts of protein in the blood or urine
- Hypercalcemia, or elevated blood calcium levels
- Osteoporosis, swollen, painful, or fractured bones
- Anaemia, or low red blood cell count or function
- Sensitivity to infections /recurring illnesses or infections that are challenging to treat
Diagnosis
Among the tests used to diagnose myeloma are:
Blood and urine test
Numerous blood and urine tests are performed in the diagnosis of myeloma. The primary blood test quantifies the kind and quantity of paraprotein present in the blood. An abnormal antibody produced by myeloma cells is called paraprotein. Bence Jones protein, a paraprotein, can be detected in the urine by testing.
X-ray
To check for bone damage from myeloma cells, X-rays of the head, spine, ribs, hips, legs, and arms are normally taken.
PET/CT scan or CT scans
CT scans are used to provide three-dimensional images that can be used to examine a body part in greater detail or to detect regions of bone deterioration that may not show up on an x-ray.
Magnetic resonance imaging (MRI):
This test produces detailed images of your spine and bones by using radio waves and powerful magnets. This test can be used by medical professionals to check for plasmacytomas. These are individual abnormal plasma cell groupings.
Bone marrow biopsy
The marrow’s cells are examined via a trephine biopsy and bone marrow aspirate. Typically, a local anaesthetic is used. A sample of bone marrow is taken with a fine needle so that it may be examined under a microscope.
Cytogenetics test
Cytogenetic testing uses a bone marrow biopsy to search for chromosome alterations in myeloma cells, which differ from healthy cells in the body. This may aid in prognosticating and treating patient.
Treatments
If multiple myeloma is causing your symptoms, your doctor might recommend the following treatments:
- Proteasome inhibitors
- Immunomodulators
- Immunotherapy
- Chemotherapy
- Radiotherapy: This procedure shrinks bone tumours and destroys cancer cells.
- Bone marrow transplant / Stem cell transplant: Your bone marrow or blood contains specialised cells called stem cells that can aid in the production of new, healthy plasma cells. Autologous stem cell transplants are usually recommended by medical professionals. During this procedure, your body’s healthy stem cells are used to replace any damaged or unhealthy ones. In rare instances, a donor could provide you healthy plasma stem cells. This transplant of stem cells is allogenic.
Prognosis
Multiple factors contribute to patient prognosis and survival, including tumour burden, cytogenetic abnormalities, age, physical fitness and co-mobilities. Myeloma treatment is always evolving; while it can help manage symptoms, control the disease, and enhance quality of life, it still lacks a cure. People typically regain their health after their myeloma is under control, and this state can endure for several months or even years before requiring additional therapy.
