What is multiple myeloma?

Multiple myeloma is a cancer that originates from a type of white blood cells called plasma cells. These cells are primarily found in the bone marrow and are an important part of the immune system, as they produce various antibodies used by our bodies to fight infections.
Multiple myeloma damages the plasma cells, which turn into cancerous cells known as myeloma cells that, instead of producing the useful antibodies, produce an excessive amount of a single antibody called paraprotein or protein M. However, this antibody is not useful to the human body. Over time, myeloma cells multiply and accumulate in the bone marrow, where they grow and mature into progenitor cells for red blood cells, white blood cells, and platelets (the cells that circulate in the bloodstream. This causes problems in various organs, primarily the kidneys.

Who gets multiple myeloma?

Multiple myeloma is the second most common blood cancer.
Globally, more than 750,000 people are living with this disease.
It is usually diagnosed as people age, peaking over age 65. The likelihood of developing myeloma is greater in male individuals. A diagnosis of monoclonal gammopathy of undetermined significance (MGUS) is a risk factor for developing multiple myeloma.

It is unclear what causes myeloma; however, as with other neoplasms, the risk is increased in people exposed to radiation for accidental or therapeutic reasons (radiation therapy) and in relatives of myeloma patients, indicating the possible contribution of acquired and congenital genetic alterations in the onset of the disease.

How is multiple myeloma diagnosed?

Multiple myeloma is a complex form of cancer. Several tests are usually needed to make an accurate diagnosis. Your doctor will decide which tests are necessary. The most common ones are listed below.
The diagnosis is made by identification of typical pathologic cells (tumor plasma cells) in the bone marrow following bone marrow aspirate and/or bone marrow biopsy. The disease is accompanied, in a high percentage of patients, by the presence in the blood of the antibody produced by the diseased cells (monoclonal component), which can be identified with a specific blood test, the serum protein electrophoresis or protidogram.
Other laboratory signs frequently present at diagnosis are altered renal function, anemia, increased antibody levels, and increased calcium.
Radiological investigations may show signs of bone erosion (osteolytic areas) or its complications (fractures).

The good news is that tremendous progress has been made in recent years in the diagnosis and treatment of multiple myeloma. Over the past two decades, intense scientific research has led to the development of several new types of drugs. 10 years ago there were only 3 innovative active ingredients, but today there are more than twice as many.