What Is Multiple Myeloma?
Multiple myeloma refers to a malignant tumor in hematological system,
originating from plasma cells (a type of white blood cell generated in the bone
marrow). Normal plasma cell is responsible for producing antibodies which can
fight against infection, while malignant plasma cell---- myeloma cell
proliferates in great numbers in the bone marrow, resulting in disorder of
patients’ life, caused symptoms such as anemia, bone pain, fracture, decreased
immunity, hypercalcemia, proteinuria, renal inadequacy, etc.
Incidence of Multiple Myeloma
Every year, there are about two out of ten thousand people diagnosed with
multiple myeloma which is believed to be the second common malignant tumors
arising from blood. It is more commonly seen in the elderly and 50-65 years old
is the high incidence age, but age of onset trends to be younger in recent
years. Men have higher incidence of multiple myeloma than women, and the ratio
is 1.6:1. With age increasing, the incidence of multiple myeloma can also rise,
which has brought more and more harm to people’s lives and their quality of
life, thus multiple myeloma has become a malignant hematological tumor that old
people cannot neglect. Besides, the occurrence of multiple myeloma has certain
relation to race, which indicates that the incidence for black people is
Causes of Multiple Myeloma
It is still not clear what cause multiple myeloma, but it may be related to
ionizing radiation, chronic antigenic stimulation, herpes virus infections
associated with EB virus or Kaposi's sarcoma. In addition, it may also be
associated with a number of cell factors, for example IL-6 which is the growth
factor of multiple myeloma.
Family Nursing Methods for Multiple Myeloma
1. Rest: patients can do appropriate activities, but never do strenuous
exercise, preventing falls and bruise.
2. Bed: in order to prevent pathologic fracture, patient should sleep on the
hard bed, so elastic bed should be avoided to use.
3. Diet: food should be high in protein, rich in vitamins and digestible.
Patients with renal dysfunction should be given low sodium, low protein diet, in
order to reduce the burden on the kidneys. If hyperuricemia and hypercalcemia
occur, patients should be encouraged to drink more water and daily urinary
volume should be maintained above 2000ml, so as to alleviate their clinical
4. Mental guide: giving patients more love and care, helping them face up to
reality, alleviating their anxieties, encouraging them to face their conditions
What kinds of supports can be obtained?
Practice proves that the clinic team services composed by multiple
disciplines like oncosurgery, oncology, pathology, imageology and anesthesia
doctors as well as professional nurses, can provide patients with most
effective, most suitable and most economic treatment plan, and also can greatly
improve the therapeutic effect of treating cancer patients.
“One station” medical system constructed by Modern Cancer Hospital Guangzhou
combining multiple disciplines, can perform comprehensive diagnosis and
treatment for patients under the condition of without adding patients’ burden.
Therefore, on one hand, it can provide all-round and heartfelt medical services,
and on the other hand, it improves medical efficiency and level. There are many
channels can be applied to conduct the communication between patients and
doctors, like online consultation, email, telephone conversation, and
face-to-face consultation. All these consultation services can effectively help
patients to fight the cancer. While the medical team faced by the patients
includes doctors, nurses, dietitians, interpreters and so on to meet various
demands in different level of different countries. Patients would be more
confident under the unobstructed communication environment to cooperate the
hospital to diagnose and treat the diseases.
Multiple myeloma (MM) is a cancer of plasma cells from B lymphocytes.
Multiple myeloma generally has no obvious symptoms in the early stage, so what
are the symptoms of multiple myeloma?
1. Bone pain: it is a main symptom. Bone pain most commonly involves the
spine and vertebrae, and then ribs. It is manifested as intermittent pain in the
beginning, gradually becomes persistent pain, and worsens with activity.
2. Infection: repeated infection is often caused, often occurring in the
lung, urinary system, skin, sinus, etc. It is more common in the advanced stage
or in the process that chemotherapy is undergone, manifests as intractable
infection, not easy to be controlled with medication, so it often becomes the
main cause of death.
3. Anemia: it results from the damage of hemopoietic system by infiltrating
tumor cells and inhibition of normal red blood cell production. Almost all
patients have different degree of anemia.
4. Renal dysfunction: it usually occurs in the early stage and about 20% of
patients develop renal dysfunction, causing uremia which leads to death.
5. Immunoglobulin abnormality: a large number of monoclonal immunoglobulin
makeas the viscosity of blood increase, resulting in slowing of blood flow and
microcirculation disorder. These kinds of patients will develop errhysis of
capillary or bleeding, numbness of limbs, cerebral dysfunction, etc.
6. Neurological symptoms: when tumor infiltrates or compresses nerves, spinal
cord and other parts, there will be corresponding symptoms appearing, such as
paralysis, urinary retention, neuropathic pain, numbness of limbs and movement
7. Other symptoms: such as high calcium deficiency, hepatosplenomegaly
(enlargement of liver and spleen), amyloidosis (AL), a few patients with
cryoglobulinemia will develop secondary Reynaud’s phenomenon.
Experts from Modern Cancer Hospital Guangzhou remind you that if found suspected
symptoms of multiple myeloma, you should go to hospital for examination and
The diagnosis of MULTIPLE MYELOMA is based upon the presence of
characteristic signs and symptoms of the disease and on the results of tests of
the blood and bone marrow. Several tests are used to determine the presence and
severity of MULTIPLE MYELOMA. In some individuals with early MULTIPLE MYELOMA or
related conditions, it may be necessary to repeat these tests periodically until
the diagnosis is certain.
Oncologist from Modern Cancer Hospital Guangzhou explains that after MULTIPLE
MYELOMA is confirmed, additional tests are used to check for the presence of
impaired kidney function, anemia, thickening of the blood, and other
complications of multiple myeloma.
Blood and urine tests for monoclonal protein — An abnormal protein produced
by the plasma cells, called a monoclonal (M) protein (sometimes called a
"paraprotein"), can be found in the blood or urine of almost all patients with
MULTIPLE MYELOMA, which helps establish the diagnosis. M proteins serve no
useful function, and may be responsible for increases in the thickness of the
blood, kidney damage, or bleeding problems. In some patients, "free light
chains" (FLCs), which represent a small portion of the paraprotein, are secreted
either in addition to the M protein or by itself. These can be measured by an
assay called the free light chain assay. The assay measures the two types of
free light chains, kappa and lambda, which are made by plasma cells, and
provides a ratio of the two.
However, doctor of Modern Cancer Hospital Guangzhou says that it is important
to remember that not everyone with a monoclonal protein has MULTIPLE MYELOMA.
The diagnosis also requires one or more abnormalities such as anemia, bone
lesions, kidney failure, or high calcium levels in the blood.
Bone marrow examination — In most individuals with MULTIPLE MYELOMA, a bone
marrow aspiration and biopsy (a collection of a small sample of bone marrow for
laboratory analysis, usually taken from the hip) shows that plasma cells
comprise an abnormally high percentage of bone marrow cells (more than 10
percent). It may be necessary to collect samples from different areas because
MULTIPLE MYELOMA can affect the marrow of some bones but not others.
Imaging — In about 80 percent of individuals, routine x-rays show distinct,
round (lytic) areas of bone erosion; generalized thinning of the bones; and/or
fractures at the time of diagnosis. The bones most comultiple myelomaonly
involved are the vertebrae, the ribs, the pelvic bones, and the bones of the
thigh and upper arm.
In some people, such as those with bone pain but normal x-rays, other imaging
tests may be done. These may include magnetic resonance imaging (MRI),
computerized tomography (CT), or positron emission tomography (PET).
Genetic and chromosomal tests — Specialized tests may reveal genetic or
chromosomal abnormalities of the plasma cells in individuals with MULTIPLE
MYELOMA. The results of these tests are helpful for predicting the response to
treatment and survival.
Oncologist from Modern Cancer Hospital Guangzhou further explains the
criteria for diagnosis of multiple myeloma which are as follow:
A bone marrow aspirate or biopsy showing that at least 10 percent of the
cells are plasma cells or the presence of a plasma cell tumor (called a
plasmacytoma), plus at least one of the following two features:
•Evidence of damage to the body as a result of the plasma cell growth, such
as severe bone damage, kidney failure, anemia, or high calcium in the blood,
•Detection of one of the following findings: ≥60 percent plasma cells in the
bone marrow; free light chain ratio of 100 or more (provided involved FLC level
is at least 100 mg/L); or MRI showing more than one lesion (involving bone or
Treatment for multiple myeloma focuses on control. Multiple myeloma patients
with stable symptoms do not need treatment but regular follow-up observations,
while those who have progressive rise of M protein in blood or urine, or have
clinical symptoms, should undergo treatment. Patients less than 70 years old
should undergo hematopoietic stem cell transplantation if conditions permitted.
For most multiple myeloma patients who have been effectively treated, the M
protein and other major index will be stable in a certain time, which is called
the platform period. In this case, the patient can undergo immunotherapy and
needs dynamic observation, etc.
What are the treatment methods of multiple myeloma?
1. Traditional chemotherapy: usage of chemical synthetic drug in treating
disease. Chemotherapy is the use of chemicals to kill tumor cells and inhibit
its growth and reproduction, as well as promote its differentiation. It is a
kind of systemic treatment method, which has therapeutic effect on the primary
lesion, metastases and subclinical metastases. The integrated use of combination
chemotherapy helps to enhance the treatment effect
2. Biological Immunotherapy
Immunotherapy is a kind of tumor biological treatment. It includes immunocyte
therapy and medicine treatment. Immunotherapy is a treatment method to stimulate
the body's own immune system to resist cancer. One of its ways is to give the
patient directly with some immune preparation, such as interferon and
⑴ Interferon: alpha interferon can improve the chemotherapy complete response
rate and prolong the disease-free survival rate.
⑵ Interleukin-2: mainly used to remove residual lesions
3.Hematopoietic stem cell transplantation
Patients under 50 years old should actively undergo hematopoietic stem cell
transplantation; and patients between 50-70 years old should take into
consideration in processing, in principle, should have it to the greatest
extent. Hematopoietic stem cell transplantation is not suitable for patients
more than 70 years old.
⑴ Autologous hematopoietic stem cell transplantation: it is a great step of
multiple myeloma treatment progress. Its treatment effect is obviously better
than that of conventional chemotherapy. Moreover, the effect of second
transplant is even better. Feasible autologous peripheral blood hematopoietic
stem cell transplantation is easy to operate and fast in hematopoietic recovery,
thus, has been widely used.
⑵ Allogeneic hematopoietic stem cell transplantation: can greatly improve the
treatment effect and is mainly used to young patients who have suitable
Targeted drugs are the most advanced medicine in the cancer treatment. It
inhibits the growth of cancer cells by affecting the specific molecular targets
necessary for cancer growth. Targeted drug treatment is to make the drugs aim at
the tumor site, so as to save relatively high concentration in local and prolong
the drug time. Thus, the tumor destruction is improved, while the normal tissue
cells are less affected.