Multiple myeloma
Multiple myeloma is a type of cancer that attacks plasma cells, a type of white blood cell in a patient's bone marrow. In general, plasma cells produce antibodies to treat infections in the body.
However, in multiple myeloma, plasma cells produce excessively abnormal proteins which can ultimately damage various organs in the body, such as the kidneys and bones.
Symptoms of multiple myeloma
Symptoms of multiple myeloma experienced by each patient are usually different. At the beginning of the disease, patients often do not feel any symptoms. Here are some of the symptoms of multiple myeloma:
Multiple myeloma is not known with certainty. Abnormal growth of plasma cells (myeloma) can multiply rapidly and exceed normal cell growth, producing antibodies that damage the body.
There are several myelomas in benign form, namely MGUS (monoclonal gammopathy with undetermined significance). MGUS is a disease characterized by the production of abnormal antibodies by myeloma cells, without causing damage to the body. However, most cases of multiple myeloma begin with MGUS. It is estimated that in about one hundred people with MGUS, one of them develops every year in multiple myeloma.
Risk Factors for Multiple Myeloma
Several factors can put a person at risk for multiple myeloma, including:
Detecting multiple myeloma is not easy because not all cases have certain symptoms. To determine whether someone really has multiple myeloma, the doctor will conduct a series of tests based on the symptoms and associated risk factors. Tests are performed to diagnose multiple myeloma and determine its stage. Some types of tests and procedures that must be performed include:
Blood tests are performed: complete blood count, kidney function, calcium levels, LDH (lactate dehydrogenase), albumin, and globulin. What is found is a decrease in Hb levels (anemia) and albumin, a decrease in the number of platelets (thrombocytopenia), as well as an increase in calcium and globulin levels.
In addition to detecting abnormal proteins in the blood, an examination called serum protein electrophoresis (SPEP), re-immunization, light chain testing (FLC) and beta-2 microglobulin are also possible. LDH and beta-2 microglobulin are used to determine the stage of multiple myeloma.
Like blood, urine samples can also be examined for abnormal proteins. The tests carried out were urine protein electrophoresis, immunofixation and free light chain (FLC) tests. In addition, 24-hour urine collection is performed to detect the amount of abnormal protein called Bence Jones protein.
Blood and tissue samples taken from bone marrow aspirations in the pelvis near the buttocks area show plasma cell growth. This procedure is done with a larger and longer needle, but with local anesthesia.
Scanners such as X-rays (bone examination), MRI, CT or PET (positron emission tomography). Digitalization is useful for detecting bone disorders associated with multiple myeloma. Scans are performed on the head, spine, arms, pelvis and legs to detect damage to this area.
From the examination carried out, the doctor can determine the stage of multiple myeloma. Multiple myeloma is divided into three stages, stage I, stage II and stage II. This step is divided according to the aggressiveness of the disease. The higher the stadium, the more aggressive the disease.
Treatment of multiple myeloma
Multiple myeloma cannot be cured yet. However, the following types of treatment can help ease pain, prevent complications, and stabilize patients by slowing the progression of multiple myeloma. With treatment, patients can continue their activities. Some treatments for multiple myeloma include:
Medications are usually given in the form of tablets, infusions, or a combination of both. Bortezomib, cyclophosphamide, melphalan, lenalidomide, thalidomide, prednisone or dexamethasone are drugs that can be given.
Decisions about the type of drug and dosage are very dependent on the condition of the patient and the immune system, because the drugs used will have side effects ranging from mild to dangerous for the patient. Patients under 65 are generally more likely to receive more aggressive treatment.
In some patients with asymptomatic multiple myeloma (called smoldering multiple myeloma), immediate treatment is not needed. However, it is necessary to monitor this disease until the first symptoms appear to get treatment.
In addition to drugs for multiple myeloma, drugs are also given to treat the symptoms and complications that accompany it. Analgesics and bisphosphonates are used to prevent bone damage and reduce calcium levels in the blood. Erythropoietin can also be used to treat anemia.
In this procedure, bone marrow infected with cancer cells is replaced by new bone marrow. Before transplantation, cancer cells are cleansed from the bone marrow using a high dose drug for multiple myeloma. Then, stem cells are inserted into the body for the purpose of forming new bone marrow.
Radiation therapy using X-rays and protons is used to destroy cancer cells and stop the growth of myeloma cells, which triggers pain and bone damage.
Dialysis is done if kidney damage occurs in kidney failure.
Surgery is performed if there are bone abnormalities to repair or strengthen the damaged bone.
Complications of multiple myeloma
The following complications may be caused by multiple myeloma, including:
Prevention of multiple myeloma
There is no specific prevention for multiple myeloma. The most important thing is that when you have been diagnosed with MGUS (monoclonal gammopathy with undetermined significance) or smoldering multiple myeloma, continue regular checkups with your doctor so that if you have multiple myeloma, you benefit from proper treatment and avoid complications. With treatment, the patient's expectation of the disease is controlled if in stage I an average of 5.5 years and if in stage III, an average of 2.5 years. After that, the disease may worsen and alternative treatment methods may be needed.
However, in multiple myeloma, plasma cells produce excessively abnormal proteins which can ultimately damage various organs in the body, such as the kidneys and bones.
Symptoms of multiple myeloma
Symptoms of multiple myeloma experienced by each patient are usually different. At the beginning of the disease, patients often do not feel any symptoms. Here are some of the symptoms of multiple myeloma:
- Nausea, loss of appetite and weight loss.
- constipation
- Pain in the bones and bones become more easily broken.
- Tired and pale.
- Susceptible to infection.
- Bleeding and bruising occur easily.
- I am often thirsty.
- Confusion or mental disorder.
- Numbness in the legs.
Multiple myeloma is not known with certainty. Abnormal growth of plasma cells (myeloma) can multiply rapidly and exceed normal cell growth, producing antibodies that damage the body.
There are several myelomas in benign form, namely MGUS (monoclonal gammopathy with undetermined significance). MGUS is a disease characterized by the production of abnormal antibodies by myeloma cells, without causing damage to the body. However, most cases of multiple myeloma begin with MGUS. It is estimated that in about one hundred people with MGUS, one of them develops every year in multiple myeloma.
Risk Factors for Multiple Myeloma
Several factors can put a person at risk for multiple myeloma, including:
- Gender. Cases of multiple myeloma are more common in men than in women.
- Age. Most myelomas are diagnosed at the age of 60 years. The risk of suffering from this disease increases with age.
- Race multiple myeloma is more common among blacks than among whites or Asians.
- Suffer from MGUS.
- Family health history. A person is at higher risk of developing multiple myeloma if a family member has this condition.
- Get fat
Detecting multiple myeloma is not easy because not all cases have certain symptoms. To determine whether someone really has multiple myeloma, the doctor will conduct a series of tests based on the symptoms and associated risk factors. Tests are performed to diagnose multiple myeloma and determine its stage. Some types of tests and procedures that must be performed include:
- Blood test
Blood tests are performed: complete blood count, kidney function, calcium levels, LDH (lactate dehydrogenase), albumin, and globulin. What is found is a decrease in Hb levels (anemia) and albumin, a decrease in the number of platelets (thrombocytopenia), as well as an increase in calcium and globulin levels.
In addition to detecting abnormal proteins in the blood, an examination called serum protein electrophoresis (SPEP), re-immunization, light chain testing (FLC) and beta-2 microglobulin are also possible. LDH and beta-2 microglobulin are used to determine the stage of multiple myeloma.
- Urine examination
Like blood, urine samples can also be examined for abnormal proteins. The tests carried out were urine protein electrophoresis, immunofixation and free light chain (FLC) tests. In addition, 24-hour urine collection is performed to detect the amount of abnormal protein called Bence Jones protein.
- Bone marrow aspiration examination
Blood and tissue samples taken from bone marrow aspirations in the pelvis near the buttocks area show plasma cell growth. This procedure is done with a larger and longer needle, but with local anesthesia.
- scanning
Scanners such as X-rays (bone examination), MRI, CT or PET (positron emission tomography). Digitalization is useful for detecting bone disorders associated with multiple myeloma. Scans are performed on the head, spine, arms, pelvis and legs to detect damage to this area.
From the examination carried out, the doctor can determine the stage of multiple myeloma. Multiple myeloma is divided into three stages, stage I, stage II and stage II. This step is divided according to the aggressiveness of the disease. The higher the stadium, the more aggressive the disease.
Treatment of multiple myeloma
Multiple myeloma cannot be cured yet. However, the following types of treatment can help ease pain, prevent complications, and stabilize patients by slowing the progression of multiple myeloma. With treatment, patients can continue their activities. Some treatments for multiple myeloma include:
- drug
Medications are usually given in the form of tablets, infusions, or a combination of both. Bortezomib, cyclophosphamide, melphalan, lenalidomide, thalidomide, prednisone or dexamethasone are drugs that can be given.
Decisions about the type of drug and dosage are very dependent on the condition of the patient and the immune system, because the drugs used will have side effects ranging from mild to dangerous for the patient. Patients under 65 are generally more likely to receive more aggressive treatment.
In some patients with asymptomatic multiple myeloma (called smoldering multiple myeloma), immediate treatment is not needed. However, it is necessary to monitor this disease until the first symptoms appear to get treatment.
In addition to drugs for multiple myeloma, drugs are also given to treat the symptoms and complications that accompany it. Analgesics and bisphosphonates are used to prevent bone damage and reduce calcium levels in the blood. Erythropoietin can also be used to treat anemia.
- Bone marrow or stem cell transplantation
In this procedure, bone marrow infected with cancer cells is replaced by new bone marrow. Before transplantation, cancer cells are cleansed from the bone marrow using a high dose drug for multiple myeloma. Then, stem cells are inserted into the body for the purpose of forming new bone marrow.
- radiotherapy
Radiation therapy using X-rays and protons is used to destroy cancer cells and stop the growth of myeloma cells, which triggers pain and bone damage.
- dialysis
Dialysis is done if kidney damage occurs in kidney failure.
- operation
Surgery is performed if there are bone abnormalities to repair or strengthen the damaged bone.
Complications of multiple myeloma
The following complications may be caused by multiple myeloma, including:
- Pain and bone damage.
- Infection.
- anemia
- Kidney function decreases.
Prevention of multiple myeloma
There is no specific prevention for multiple myeloma. The most important thing is that when you have been diagnosed with MGUS (monoclonal gammopathy with undetermined significance) or smoldering multiple myeloma, continue regular checkups with your doctor so that if you have multiple myeloma, you benefit from proper treatment and avoid complications. With treatment, the patient's expectation of the disease is controlled if in stage I an average of 5.5 years and if in stage III, an average of 2.5 years. After that, the disease may worsen and alternative treatment methods may be needed.
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