- Myeloma develops in plasma cells, a type of white blood cell found within the bone marrow
- Although myeloma is found in the bone marrow, it is classified as a type of blood cancer
- Myeloma is most commonly diagnosed in men over the age of 60
Myeloma, also known as multiple myeloma, refers to cancer which develops in the bone marrow (the spongy tissue found inside your bones).
The most common types of myeloma include:
This is an early-stage myeloma which develops from plasma cells in a single area, such as in a bone.
Smouldering (asymptomatic) myeloma
This type of myeloma is considered early-stage and typically does not cause symptoms. However, most smouldering myeloma cases will go on to become active myeloma.
Active (symptomatic) myeloma
Myeloma is classified as active when it begins causing symptoms. Characteristics of active myeloma include having m-protein in your blood or urine, plasma cells that make up at least 10% of the blood cells found in your bone marrow and myeloma tumours in your bone or soft tissue.
Extramedullary plasmacytomas develop in soft tissue outside the bone marrow. These tumours are commonly found in the upper respiratory tract, however they may also occur in the gastrointestinal tract, breast or brain.
Light chain myeloma
Light chain myelomas make up 15 to 20 percent of myeloma cases and are commonly found in the kidneys. This type of myeloma is smaller and is commonly detected through urine tests.
As signs and symptoms for myeloma can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a myeloma diagnosis.
Myeloma can be difficult to detect as certain types of myeloma may not cause any symptoms. However, symptoms can include:
Fatigue and tiredness as a result of low iron (anaemia)
Increased frequency of fractures or broken bones
Pain in the bones, often felt in the back and rib area
Bruising and bleeding that occurs easily
The Revised International Staging System (R-ISS) is used to stage myeloma, and it helps doctors understand what your cancer looks like. This staging system uses various blood tests to measure the following features:
- Chromosomal changes – Cytogenic testing can check for chromosomal changes that may affect abnormal genes, such as missing pieces of chromosome 17, translocation (exchange of pieces of material) between chromosomes 4 and 14, as well as translocation between chromosomes 14 and 16
- Lactic dehydrogenase (LDH) – High levels of LDH, an enzyme involved in cell metabolism, in the blood can be a sign that your myeloma is more advanced
- Albumin – Lower levels of albumin, a protein found in the blood, may be seen in myeloma
- Beta-2-microglobulin (B2M) – Higher levels of the protein beta-2-microglobulin, which is made by myeloma cells, are associated with poorer prognosis for myeloma patients
The R-ISS information, along with other tests, helps determine the stage of your myeloma using the guidelines below:
Serum B2M is less than 3.5 mg/L, albumin is at least 3.5 g/L, LDH are normal and cytogenetics are not considered high risk.
Levels will fall between stages I and III, but no other guidelines are set.
Serum B2M is at least 5.5 mg/L. Additionally, either LDH levels will be high or cytogenetics will be high risk.
Myeloma is not genetic (passed on from a parent to a child) and it is relatively rare for more than one family member to have myeloma. However, having a first degree relative with myeloma gives you a slightly increased risk of developing myeloma.
The cause of myeloma is not fully known, however there are some factors which contribute to the risk of myeloma developing, including:
- Exposure to high levels of radiation and certain chemicals such as dioxins
- Contracting HIV
In 2021, it’s estimated that nearly 2 500 people will be diagnosed with myeloma. It is the least common of all blood cancers (including lymphoma and leukaemia), making up 15% of all blood cancer diagnoses.
Risk factors that have been associated with developing myeloma include:
- Age – Myeloma is most common in people over the age of 60
- Gender – There is a higher rate of myeloma in men compared to women
- Weight – Being overweight or obese increases your risk of developing multiple myeloma
- Exposure – You have an increased risk of developing myeloma if you are exposed to certain chemicals (including dioxins), radiation or certain viruses (including HIV)
Your doctor may refer to the CRAB or SLiM-CRAB criteria to help determine if you may have myeloma. These criteria include:
- C: Elevated calcium levels
- R: Renal (kidney) damage
- A: Anaemia
- B: Bone pain and damage
- S: Plasma cells in the bone marrow are considered 60% abnormal or greater
- Li: High level of free light chains are found in the blood
- M: Bone lesions are found on the MRI scan
- Cancer Council NSW. (n.d). Staging and prognosis for myeloma. Retrieved 21 December 2021 from www.cancercouncil.com.au/myeloma/diagnosis/staging-prognosis/
- Cancer Council. (September 2020). Myeloma. Retrieved on 21 December 2021 from https://www.cancer.org.au/cancer-information/types-of-cancer/myeloma
- Cancer Australia, Australian Government. (2018). What are the symptoms of myeloma? Retrieved on 2nd April from https://myeloma-cancer.canceraustralia.gov.au/symptoms
- American Cancer Society. (2018). Risk factors for multiple myeloma. Retrieved on 11th April 2019 from https://www.cancer.org/cancer/multiple-myeloma/causes-risks-prevention/risk-factors.html
- American Cancer Society. (2018). Multiple Myeloma Stages. Retrieved on 11th April 2019 from https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/staging.html
- American Cancer Society. (2018). Tests to find multiple myeloma. Retrieved on 11th April 2019 from https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/testing.html
- Leukaemia Foundation. (2018) Myeloma – A guide for patients and families. Retrieved on 11th April 2019 from https://www.cancer.org/cancer/multiple-myeloma/treating/by-stage.html
- American Cancer Society. (2018). Treatment options for multiple myeloma, by stage. Retrieved on 11th April 2019 from https://www.cancer.org/cancer/multiple-myeloma/treating/by-stage.html
- Myeloma UK. (n.d). Smouldering Myeloma. Retrieved on 11th April 2019 from https://www.myeloma.org.uk/understanding-myeloma/related-conditions/smouldering-myeloma/
- Canadian Cancer Society. (2014). Types of multiple myeloma. Retrieved on the 11th April 2019 from https://cancer.ca/en/cancer-information/cancer-types/multiple-myeloma/what-is-multiple-myeloma/types-of-multiple-myeloma
Helpful linksBecoming a patient
The long road with myeloma
Danny discusses his long road with myeloma and finding the silver lining
What you need to know about cancer research and clinical trials
View a Facebook Live with Icon specialists from across Australia and Singapore
Keeping the motor running – a life with multiple myeloma and MDS
How Icon Adelaide patient Paul found his new normal
Clinical Opinion Article
Five tips for life beyond cancer treatment
Icon Medical Director and Clinical Haematologist Dr Ian Irving shares his advice on how to stay well and find your new normal once treatment ends
Become a patient
Find out how to become a patient at Icon Cancer Centre, or request more information from your nearest centre.
Icon brings together some of Australia’s most experienced medical oncologists, radiation oncologists and haematologists.
Care at Icon
At Icon, care is more than just a word. Our cancer care team are here to support you with compassion, knowledge and hope.
Our patients share their perspective and advice.