Multiple Myeloma

Definition

Multiple myeloma is a cancer that starts in the bone marrow. It results from the abnormal growth of plasma cells. 浆细胞是白细胞 这通常有助于抵抗感染. In multiple myeloma, a group of plasma cells:

• Make abnormal proteins that collect in blood and urine
• Can form into a tumor and destroy the bone around it

These events can lead to bone pain, kidney damage, and a weak immune system.

成人骨髓部位

Copyright © Nucleus Medical Media, Inc.

Causes

Cancer happens when cells in the body divide without control or order. If cells keep dividing, a mass of tissue forms. 这些被称为生长或 tumors. If a tumor is cancer it is called malignant. 肿瘤可以侵入附近的组织 and spread to other parts of the body.

The exact cause of multiple myeloma is unknown. It is likely due to immune problems, genes, and the environment.

Risk Factors

Multiple myeloma is more common in people 65 years old or older. It is also more common in people who are Black. Other things that may raise the risk are:

• Having MGUS—an abnormal protein in the blood
• Exposure to nuclear radiation, petroleum products, or pesticides

Symptoms

Symptoms of early stage multiple myeloma include:

• Persistent, often severe bone pain that:
• Tiredness

When the disease gets worse, symptoms may include:

• 越来越疲倦和虚弱
• Broken bones
• Repeat infections
• Nausea and vomiting
• Constipation
• 排尿(小便)困难
• Abnormal bleeding
• Headache, vision problems, or confusion

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Imaging tests will look for bone problems. These may include:

• X-rays
• MRI scan
• CT scan
• PET/CT scan

Other tests will help make the diagnosis, including:

Blood and urine tests—to look for certain proteins

骨髓抽吸及 biopsy—to look for abnormal cells in bone marrow, blood, and bone.

Tests are used to find the stage of the cancer. 多发性骨髓瘤是1到3期. Stage 1 is less aggressive than stage 3. The number of tumors in the bone are also used 评估前景.

Treatment

The goal of treatment is to ease pain, manage problems, and slow 多发性骨髓瘤的进展. 完全缓解是罕见的.

Some people have slow-growing myeloma without symptoms. 他们可能不需要治疗 right away. The doctor will wait and watch for signs that need treatment.

If treatment is needed, it will depend on the symptoms and the stage. Options may include one or more of the following:

有些人可能有 外周干细胞移植. Young, healthy blood cells will replace bone marrow cells that are damaged by cancer. This procedure depends on the person's age, health, and cancer outlook.

其他治疗方法包括:

• Plasmapheresis-交换血浆 blood. Plasma is the liquid part of blood that does not contain cells. After plasma is removed, fresh plasma or a plasma substitute is added back to the blood. This treatment removes the abnormal proteins from the blood.
• Bisphosphonates—drugs to slow the process of bone loss.
• Surgery—to remove a tumor that causes pain or other problems. This may be done if 辐射没有帮助.

Other treatments may be needed for anemia, infections, or kidney problems.

Prevention

There are no current guidelines to prevent multiple myeloma.

References

• diopoulos MA, Moreau P，等. 多发性骨髓瘤:EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021;32(3):309-322.
• Multiple myeloma. 美国癌症协会网站. Available at: http://www.cancer.org/cancer/multiple-myeloma.html.
• Multiple myeloma. EBSCO DynaMed网站. Available at:http://www.dynamed.com/condition/multiple-myeloma.
• Plasma cell neoplasms (including multiple myeloma) treatment (PDQ)病人的版本. 国家癌症研究所网站. Available at: http://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq.