Multiple Myeloma

Multiple Myeloma

Multiple myeloma is a cancer that attacks the plasma cells in the bone marrow. Plasma cells are a type of white blood cell that function to form antibodies. Generally, this cancer causes symptoms in the form of bone pain , especially in the spine and pelvis .

Multiple myeloma is a type of blood cancer . This condition occurs when abnormal (abnormal) plasma cells grow and develop excessively and interfere with healthy cells around them.


These cancer cells also produce abnormal antibodies. In addition to not being able to function to protect the body, the accumulation of abnormal antibodies can damage certain organs, such as the kidneys.

Causes of Multiple Myeloma

Multiple myeloma occurs when abnormal plasma cells (myeloma) in the bone marrow grow and develop very quickly. These abnormal plasma cells also damage healthy cells, such as red blood cells, white blood cells, and platelets (platelets).

Under normal circumstances, plasma cells will produce antibodies that function to protect the body (M protein). When plasma cells become myeloma, the antibodies they produce don't work as they should. M protein eventually accumulates and damages several organs, such as the kidneys, bones, and nervous system.

The exact cause of multiple myeloma is not known. However, this condition is often associated with MGUS ( monoclonal gammopathy of undetermined significance ). It is estimated that 1 in 100 MGUS sufferers will develop multiple myeloma.

Multiple myeloma risk factors

There are several factors that can increase a person's risk of developing multiple myeloma, namely:

  • Male gender
  • Over 65 years old
  • Have a family history of multiple myeloma or MGUS
  • Suffering from being overweight or obese
  • Have been exposed to radiation, for example from undergoing radiotherapy
  • Have a history of exposure to or contact with chemicals, for example in oil workers

Symptoms of Multiple Myeloma

In the early stages, people with multiple myeloma often do not feel any symptoms. However, as the disease progresses, the following symptoms may appear:

  • Bone pain, especially in the spine, ribs, and pelvis
  • Vulnerable to fracture
  • Vulnerable to infection
  • Legs feel weak to numb (numbness)
  • Easy bruising on the skin, nosebleeds, or bleeding gums
  • Nausea and vomiting
  • Loss of appetite
  • Drastic weight loss
  • Anemia
  • Stomach pain and constipation
  • Often tired and weak
  • Headache
  • Blurred vision
  • daze

When to go to the doctor

Immediately see a doctor if you experience the symptoms mentioned above. Symptoms of this condition are often atypical. Therefore, early examination is needed to determine the cause of the complaint. If it is caused by multiple myeloma, early treatment can be done to prevent complications.

If you are at risk for multiple myeloma, such as a family history of MGUS, have a medical check-up every 5 years if you are 18–40 years old, or annually if you are over 40 years old. It is necessary to monitor your health condition.

If you have been diagnosed with multiple myeloma, follow the therapy and examination schedule given by your doctor so that your condition can be monitored.

Multiple Myeloma Diagnosis

To diagnose multiple myeloma, the doctor will ask the patient's symptoms, as well as the patient's and family's medical history. After that, the doctor will perform an examination to detect signs of bleeding, such as bruising and signs of infection, such as fever.

To confirm the diagnosis, the doctor will perform the following investigations:

  • Blood tests , to detect anemia, hypercalcemia, M protein levels, albumin levels, beta-2 microalbumin (B2M), lactat dehydrogenase (LDH), genetic changes, and to determine kidney function
  • Urine test , to detect the presence of M protein in the urine
  • Scans with X-rays, MRI, CT scans, or PET scans , to determine bone structure and detect damage caused by multiple myeloma
  • Bone marrow aspiration , to check the number and appearance of plasma cells in the bone marrow, as well as the presence of cancer cells in the bone marrow

The investigation also aims to determine the severity of the patient's condition. By knowing the severity, the doctor can provide the appropriate type of treatment to the patient.

Multiple Myeloma Treatment

Multiple myeloma cannot be cured. However, treatment is still needed to control the growth of cancer cells, prevent complications, and relieve symptoms.

The following are some methods of treating multiple myeloma:


Forms of drugs to treat multiple myeloma can vary, ranging from oral drugs to injections. Some types of drugs that can be given by doctors are:

  • Targeted therapies, such as bortezomib and carfilzomib, to inhibit and stop the growth of cancer cells (myeloma)
  • Biological drug therapy, such as thalidomide and lenalidomide , to improve the patient's immune system so that it can fight myeloma cells
  • Chemotherapy , to kill cells that are growing too fast including myeloma cells
  • Corticosteroids , such as prednisone and dexamethasone , to regulate the immune system that controls inflammation

In addition to the drugs mentioned above, the doctor will also provide some supporting drugs, such as:

  • Medications to prevent bone breakdown, such as bisphosphonates
  • Medications to relieve pain, such as paracetamol
  • Drugs to increase blood and treat anemia , such as erythropoietin


Radiotherapy is a therapy using high-energy rays, namely X - rays , to destroy and stop the growth of myeloma cells. This therapy is usually used when you want to destroy myeloma cells in specific areas of the body.

Bone marrow or stem cell transplant

A bone marrow transplant is a procedure to replace abnormal cells in the bone marrow with healthy bone marrow cells. These healthy bone marrow cells can come from patient stem cells or stem cells from donors.

Multiple Myeloma Complications

If not treated immediately, multiple myeloma can cause various complications, including:

  • Disorders of the bones, such as bone pain, brittle bones, and broken bones
  • Easy to get infected
  • Anemia and thrombocytopenia
  • Kidney failure

Multiple Myeloma Prevention

There is no specific prevention for multiple myeloma. However, there are several things that can be done to reduce the risk of this condition, namely:

  • Check regularly with your doctor, especially if you have been diagnosed with MUGS or have an immune system disorder.
  • Adhere to established safety standards when working, especially if you are at risk of exposure to chemicals.
  • Apply a healthy and balanced diet, especially by eating healthy and balanced nutritious foods.
  • Keep your weight within the ideal range , by adopting a healthy diet and exercising regularly.
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