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 cells that function to form antibodies. Generally, this cancer causes symptoms in the form of bone pain , especially in the spine and pelvic bones .

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

These cancer cells also produce abnormal antibodies. Apart from being unable 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.

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

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

Multiple myeloma risk factors

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

  • Male gender
  • Age over 65 years
  • Have a family history of multiple myeloma or MGUS
  • Suffering from overweight or obesity
  • Have been exposed to radiation, for example due to radiotherapy
  • Have a history of exposure or contact with chemicals, for example in oil workers

Symptoms of Multiple Myeloma

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

  • Bone pain, especially in the spine, ribs and pelvis
  • Vulnerable to fractures
  • Vulnerable to infectious diseases
  • Legs feel weak to numb (numb)
  • Easy bruising on the skin, nosebleeds, or bleeding gums
  • Nausea and vomiting
  • Loss of appetite
  • Weight loss drastically
  • Anemia
  • Abdominal pain and constipation
  • Often tired and weak
  • Headache
  • Blurred vision
  • dazed

When to see a doctor

Immediately consult a doctor if you experience the symptoms mentioned above. The symptoms of this condition are often atypical. Therefore, early examination is needed to find out the cause of these complaints. If it is caused by multiple myeloma, early treatment can be done to prevent complications.

If you have a risk of developing multiple myeloma, such as a family history of MGUS, do a medical check-up every 5 years if you are 18–40 years old, or every year 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 the doctor so that your condition can be monitored.

Diagnosis of Multiple Myeloma

To diagnose multiple myeloma, the doctor will ask about the symptoms experienced by the patient, as well as the medical history of the patient and his family. After that, the doctor will conduct an examination to detect signs of bleeding, such as bruising and signs of infection, such as fever.

To confirm the diagnosis, the doctor will carry out the following supporting examinations:

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

The supporting examination 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.

Treatment of Multiple Myeloma

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

The following are several methods of treating multiple myeloma:


The forms of medicines for treating multiple myeloma can vary, from oral medications 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 (myeloma) cells
  • Biological drug therapy, such as thalidomide and lenalidomide , to boost the patient's immune system so it can fight myeloma cells
  • Chemotherapy , to kill cells that grow too fast including myeloma cells
  • Corticosteroids , such as prednisone and dexamethasone , to regulate the immune system which controls inflammation

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

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


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

Bone marrow or stem cell transplant

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, porous bones, and broken bones
  • Easy to get infection
  • Anemia and thrombocytopenia
  • Kidney failure

Prevention of Multiple Myeloma

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

  • Check regularly with your doctor, especially if you have been diagnosed with MUGS or have disorders of the immune system.
  • Comply with safety standards that have been set when working, especially if you are at risk of exposure to chemicals.
  • Adopt a healthy and balanced diet, especially by eating healthy and nutritionally balanced foods.
  • Maintain body weight within the ideal range , namely by adopting a healthy diet and exercising regularly.
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