Multiple Myeloma

In many cases, the cause of multiple myeloma is unknown. However, certain genetic mutations put people at greater risk for developing the disease. These mutations are acquired, meaning they are not passed down through families. The mutations that lead to myeloma likely occur spontaneously as people age.

Tests and procedures used to diagnose multiple myeloma may include:

• Blood tests: Myeloma blood work tries to help us understand the nature of your disease and how it is affecting your body:
  • Tests about the nature of your disease: Antibodies normally protect us from infection. Myeloma cells make antibodies that shouldn’t otherwise be there. Myeloma blood work tells your doctor more about these abnormal antibodies. Some tests you might see in your medical record include:
    • Serum protein electrophoresis: This test lets your doctor test for an M protein (monoclonal proteins), a type of abnormal antibody made by myeloma cells.
    • Kappa/lambda ratio: This is another test that tells your doctor about the antibodies in your blood. Each antibody has a kappa part or a lambda part. Your body usually makes an even about of kappa family and lambda family antibodies. Myeloma can cause one family to grow more numerous than the other.
  • Tests on how myeloma affects your body: Myeloma can hurt the kidneys, make you anemic and disturb the balance of your electrolytes. Your doctor will order tests to see how myeloma is affecting your body. These tests may include:
    • A complete blood count tests your good blood counts and can tell your doctor if you are anemic (have low levels of healthy red blood cells). If you’re anemic, you may feel more tired.
    • A comprehensive metabolic panel tests how your kidneys are working and checks your electrolytes.
  • Urine tests: M proteins can be detected in urine samples. When found in the urine, M proteins are referred to as Bence Jones proteins.
  • Bone marrow samples: Samples are typically taken from the hip bone. Bone marrow has both a solid and a liquid component. Bone marrow biopsy collects a small amount of solid tissue, while bone marrow aspiration collects bone marrow fluid. Samples are tested for the presence of myeloma cells. Additional tests, like the fluorescence in situ hybridization (FISH), can give your healthcare providers more information about your multiple myeloma.
  • Imaging tests used to identify bone issues caused by multiple myeloma may include:
    • Bone/skeletal survey (an X-ray of all the bones in the body)
    • Magnetic resonance imaging (MRI) scan
    • Whole body, low-dose computed tomography (CT) scan
    • Positron emission tomography and computed tomography (PET-CT) scan

Led by national experts, our myeloma team works collaboratively as part of a hematologic malignancy tumor board to discuss each patient’s treatment plan. Using state-of-the-art technology and the most targeted therapies, our team personalizes each phase of a patient’s myeloma management plan.

Because multiple myeloma affects the immune system, our specialists determine the best treatment plan based on individual needs and other complications, including anemia, bone or kidney issues. From diagnosis through every phase of treatment, including stem cell transplant if necessary, the same clinical team delivers each patient’s care.

For some patients, treatment for multiple myeloma isn’t needed right away. If you don’t have symptoms, you may be tested over time to monitor your multiple myeloma. If symptoms progress, treatment typically starts with medicine. Treatment can help slow the growth of myeloma cells, relieve pain, and manage or reduce complications.

Treatment options for multiple myeloma include:

• Targeted therapy: Targeted therapy interferes with cancer growth by targeting specific chemicals and cellular activities in the cancer cells.
• Immunotherapy: Cancer cells survive by hiding from the immune system. Immunotherapy works by stimulating your own immune system proteins to recognize and destroy cancer cells. Types of immunotherapy for multiple myeloma include chimeric antigen receptor (CAR) T-cell therapy, which uses the body’s own T-cells, a type of white blood cell, to fight the cancer.
• Chemotherapy: Chemotherapy is the use of certain drugs to destroy cancer cells.
• Corticosteroids: Corticosteroids are manmade drugs that closely resemble cortisol, a hormone the adrenal gland produces naturally. In the management of multiple myeloma, corticosteroids are used to reduce inflammation around tumors, relieve pain, and provide relief from side effects caused by other treatments, including nausea and vomiting from chemotherapy.
• Bone marrow transplant: A bone marrow transplant, also called a stem cell transplant, replaces diseased bone marrow with healthy bone marrow.
• Radiation therapy: Radiation therapy is a type of cancer treatment that uses powerful energy beams to destroy cancer cells.

Multiple myeloma is the most common blood cancer in black people, affecting twice as many black people as white patients. Black people are also diagnosed with the disease an average of 5 to 10 years earlier. Nationwide, many black people with multiple myeloma also face disparities in care, including barriers to appropriate treatment.

The diversity of the cancer team at UH Seidman Cancer Center reflects the diversity of the patient population we serve. We’re committed to reducing healthcare disparities, and we continually strive to provide all of our patients with access to the best care.

Although there is currently no cure for myeloma, the disease is highly treatable in many patients. With an ever-increasing number of new and effective treatment options available, the life expectancy of myeloma patients continues to improve.

It’s important to remember that survival rates vary from one person to another, depending on the type and stage of the cancer, the patient’s age and overall health, and other factors. Average survival rates also don’t reflect the most recent advances in treatment. With continuing improvements in treatment, multiple myeloma has the potential to be managed as a chronic condition for many patients.