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Myeloma-Overview

Also known as plasma cell myeloma and Kahler’s disease, this is a cancer of plasma cells (a type of white blood cells located in the bone marrow that are responsible for the production of antibodies).

Myeloma is an accumulation of cancerous plasma cells. Cancer is a disease that is characterized by the transformation of normal cells into abnormal cells that start to grow and multiply uncntrollably. The net effect is the emergence of large numbers of abnormal cells that are capable of forming tumors, with the capability to advance locally and invade neighboring tissues and organs or spread either through the lymphatics or the blood vessels into distant organs (this is known as metastasis and such cancer a metastatic cancer).

In multiple myeloma, a group of abnormal plasma cells multiplies, thus raising the number of plasma cells. Since, these cells normally make proteins, the level of abnormal proteins in the bloodstream also might go up. Problems caused by multiple myeloma can have bad effect on bones, immune system, kidneys and red blood cell count.

Causes of Myeloma

The actual cause of myeloma is yet unknown, still, there are certain risk factors that might contribute to one getting myeloma. These include: genetic abnormalities, certain viral infections, exposures to certain chemicals and other conditions in the workplace (petrochemical industry workers, leather workers, shipyard workers, metallurgic industry workers, book binders, etc.), exposure to very large doses of radiation, and immune system dysfunction.

Symptoms

Symptoms of myeloma may vary from person to person. Some might not experience any, while others might experience severe ones.
The most common symptoms of myeloma include: bone pain (in the back, ribs, skull, or pelvis), the presence of monoclonal proteins in the urine (this is usually detected during a normal examination), elevated levels of calcium in the blood (which leads to constipation, increased thirst, mental confusion, loss of appetite, nausea and frequent urination).

Stages

There are two staging systems for describing myeloma.

The Durie-Salmon staging system. With this staging system, there exist 3 stages of myeloma:

  • Stage I. The patient has normal levels of calcium in the bloodstream, no anemia, low levels of immunoglobin in the blood and no bone damage.
  • Stage II. This stage is diagnosed if the patient’s symptoms do not fit into stage I or stage III.
  • Stage III. The patient has anemia, high levels of calcium in the bloodstream, elevated levels of abnormal paraproteins in the blood and more than three sites of bone damage.

The Durie-Salmon staging system, however, is being replaced by the newer, International Staging System. By this system, there are three stages of mylenoma. They are determined by the results of two blood tests (ß2-microglobulin and albumin).  
Doctors use this system now to predict how the patient might respond to treatment.

Classifying Myeloma


To classify the disease, the doctors look whether the myeloma affects the body tissue and organs and causes any symptoms.
They then classify it as asymptomatic (smouldering) or symptomatic.

Asymptomatic means that the patient has elevated levels of abnormal paraprotein in the blood, no related tissue or organ impairment, and high levels of abnormal plasma cells in the bone marrow.

Symptomatic means that one has any level of abnormal paraprotein in the blood, has plasmacytoma and damage to the surrounding tissue or organs.

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