Multiple Myeloma, often simply referred to as myeloma, is a hematologic cancer, or blood cancer, characterized by the formation of malignant plasma cells in the bone marrow. Both the incidence and survival rates of myeloma have been increasing in recent years, primarily due to advances in detection methods and therapies, making knowledge about this pathology of high importance.
Commencing at its basics, plasma cells are responsible for the production of antibodies to fight infections, supporting the immune system in the body. However, in myeloma, these cells become cancerous and multiply in an uncontrolled manner, crowding out the normal healthy cells. Allowing lethal consequences is the generation of harmful proteins, diminishing kidney function and leading to bone lesions.
The symptoms of myeloma, unfortunately, are not unique and include nonspecific signs such as bone pain, fatigue, frequent infections, and weight loss which makes the disease often hard to diagnose in early stages. More specific signs, including increased calcium levels and kidney problems, appear in later stages of the disease.
One of the key reasons why myeloma is a challenge to manage is its heterogeneity. The disease can manifest differently in different people, and even within a single individual, there may exist different types of malignant cells. This applies particularly to relapsed or refractory myeloma, meaning the disease remains or recurs despite treatment.
The diagnosis of myeloma is based on blood and urine tests, as well as imaging and invasive procedures like biopsy. These tests are aimed at detecting the increased number of plasma cells and distinctive proteins, and also at checking the condition of the kidneys, bones, and other organs.
The treatment modalities of myeloma have evolved substantially over the past decade. While chemotherapy and radiation therapy were previously mainstays in the treatment plan, newer generations of immunomodulatory drugs and targeted therapies have taken center stage. Autologous stem cell transplantation, where a patient's own stem cells are collected and then reintroduced following high-dose chemotherapy, is also a common treatment process.
Despite these advances, myeloma is currently incurable, with patients often experiencing multiple relapses. The median survival is approximately 5 years, but varies widely based on numerous factors, such as genetic characteristics and the initial response to treatment.
Research on myeloma is ongoing, with new, more effective, and less toxic drugs continually being developed and tested in clinical trials. Emphasis is also placed on understanding the biological differences causing the observed heterogeneity in Myeloma. By exploring these differences, it might be possible to get closer to personalized, targeted treatments, thus improving both the quality and length of life for those living with this disease.
The relatively low prevalence of myeloma combined with its complex nature accentuates the importance of patient education and specialist care in managing this disease.