Myeloma, also known as multiple myeloma, is a cancer arising from plasma cells, a type of white blood cell which is made in the bone marrow. Bone marrow is the ‘spongy’ material found in the centre of the larger bones in the body. The bone marrow is where all blood cells are made.
Plasma cells form part of your immune system. Normal plasma cells produce antibodies, also called immunoglobulins, to help fight infection.
In myeloma, plasma cells become abnormal, multiply uncontrollably and release only one type of antibody known as paraprotein, which has no useful function. It is often through the measurement of this paraprotein that myeloma is diagnosed and monitored.
Unlike many cancers, myeloma does not exist as a lump or tumour. Most of the symptoms and complications related to myeloma are caused by the build-up of the abnormal plasma cells in the bone marrow and the presence of the paraprotein in the blood and/or in the urine.
Myeloma affects multiple places in the body (hence ‘multiple’ myeloma) where bone marrow is normally active in an adult, ie within the bones of the spine, skull, pelvis, the rib cage, long bones of the arms and legs and the areas around the shoulders and hips.
Myeloma is a relapsing-remitting cancer. This means there are periods when the myeloma is causing symptoms and/or complications and needs to be treated, followed by periods of remission or plateau where the myeloma does not cause symptoms and does not require treatment.
Treatment of Myeloma
Treatment is aimed at controlling the myeloma, relieving the symptoms and complications it causes and improving patient’s quality of life.
Myeloma treatment is almost always with a combination of drugs over periods of time known as cycles. Cycles may last from weeks to months. The best treatment combination is based on a number of factors:
General health and how fit you are
Any previous treatments
Genetic subtype of your myeloma
Treatment is generally divided into two groups:
Non-intensive – for older/less fit and elderly/frail patients
Intensive – for younger/fitter patients
Treatment combinations are usually made up of two or three different types of drugs which work well together and can include chemotherapy drugs (eg cyclophosphamide and melphalan), steroids (eg dexamethasone and prednisolone) and other types of anti-myeloma drugs (eg thalidomide, Velcade® (bortezomib) and Revlimid® (lenalidomide)).
For more information on lymphoma please do not hesitate to get in touch with Dr Shafeek through our appointments page.