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Myeloma

Myeloma (also known as multiple myeloma) is a cancer of the bone marrow.

What is Myeloma?

Myeloma is a malignancy of the plasma cells, which is a type of white blood cell within the bone marrow (the spongy tissue within the bone). Bone marrow is predominantly found in the spine, pelvis, ribs, skull and shoulders.2

Plasma cells are part of the immune system and produce antibodies that help bacteria and other pathogens.2 When plasma cells become malignant, they multiply and spread throughout the bone marrow so that there is less room for healthy cells to develop and grow. 2

Myeloma is often known as multiple myeloma (and occasionally as myelomatosis or plasma cell myeloma) due to the multiple sites of bone marrow lesions found at diagnosis.2

Signs and symptoms of Myeloma

Some common symptoms of myeloma include; 1

  • Fatigue and tiredness as a result of low iron (anaemia)
  • Temperatures
  • Chronic infection
  • 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

Having one or all of these symptoms does not mean you have myeloma, as many conditions can cause these symptoms. However, it is important if you do experience any of the above, to see your doctor.

Stages of myeloma

The stages of multiple myeloma are based on the Revised International Staging System (R-ISS). 4

The stages range from stage 1 (early stage myeloma) through to stage 3 (more advanced myeloma). This staging system is based on following four features: 4

  • The chromosomal changes that have affected the abnormal genes – which can be tested via cytogenic testing. There are three chromosomal changes that are considered ‘high risk’ for a poorer outcome of myeloma:4
    • Missing pieces of chromosome 17
    • Translocation (exchange of pieces of material) between chromosomes 4 and 14
    • Translocation between chromosomes 14 and 16
  • The level of lactic dehydrogenase (LDH) in the blood. LDH is an enzyme involved in cell metabolism. A high LDH suggests the disease is more advanced.5
  • The amount of albumin (type of protein) in the blood. Lower levels of albumin are seen in myeloma. 5
  • The amount of beta-2-microglobulin (type of protein made by myeloma cells) – higher levels of this protein is associated with a poorer prognosis. 5

Myeloma research at Icon

Our research centre at Icon offers Australia the largest private clinical trials programme in cancer research, with over 35 clinical trials currently open for recruitment.  Clinical trials specific to myeloma research can be found here.

Icon’s collaborative approach to clinical trial research not only enables continual advancement and breakthroughs in myeloma research, but also enables the most up to date treatment options are available to all patients regardless of health insurance.

Treatment for myeloma

Treatment of myeloma will be dependent on your type of myeloma, current health and medical history as well as your treatment preference.

Treatments are typically based on the classification of myeloma:

  • Solitary plasmacytoma – is where only one myeloma lesion is found, and it can often be treated with radiotherapy alone.6

 

  • Smouldering (or asymptomatic) myeloma – is an early form of myeloma and depending on how cancerous the plasma cells are, determines when treatment (such as chemotherapy) will start or whether it can be watched closely without treatment. 7a

 

  • Active (or symptomatic) myeloma – people with this stage of myeloma are usually given a combination of treatments with options including: chemotherapy, immunotherapy, stem cell transplant and radiation therapy. 7, 8.

Frequently asked questions

Is myeloma hereditary?

Myeloma is not genetic ie. Is not passed on from parent to offspring, and it is relatively rare for more than one family member to have myeloma.2  However having a first degree relative with myeloma gives you a slightly increased risk of developing the disorder.

The exact cause of multiple myeloma is not known, but gene mutations that result in myeloma seem to be acquired through exposure to certain viruses such as HIV, chemicals such as dioxins and high-level radiation in some patients. 2

Are there risk factors for myeloma?

Some factors that can increase the risk of developing myeloma include;1,2,3

  • Age – multiple myeloma is often diagnosed in people over the age of 65 years
  • Men are slightly more likely to develop multiple myeloma compared to women
  • Being overweight or obese increases the risk of developing multiple myeloma
  • Exposure to certain chemicals, such as dioxins as well as exposure to radiation can increase the risk
  • Exposure to certain viruses such as HIV have also been associated with an increased risk of myeloma.
How common is myeloma?

Myeloma accounts for approximately 1750 cancer diagnoses in Australia each year. It is the least common of the blood cancers (lymphoma and leukaemia), making up 15% of all blood cancers.2

References

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