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Multiple Myeloma

A type of cancer that begins in plasma cells (white blood cells that produce antibodies).

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Multiple Myeloma

In multiple myeloma, abnormal plasma cells (myeloma cells) build up in the bone marrow and form tumors in many bones of the body. These tumors may keep the bone marrow from making enough healthy blood cells. Normally, the bone marrow makes stem cells (immature cells) that become three types of mature blood cells:

As the number of myeloma cells increases, fewer red blood cells, white blood cells, and platelets are made. The myeloma cells also damage and weaken the bone....Read more about Multiple Myeloma NIH - National Cancer Institute

What works? Research summarized

Evidence reviews

Early treatment for early stage multiple myeloma may slow the disease progression but does not appear to improve survival

Multiple myeloma (MM) is cancer of the bone marrow. It causes bone destruction that leads to pain, spinal cord compression and fractures.In early stages, most people do not show any symptoms of MM. It is not clear whether it is better to start treatment with cancer drugs straight after diagnosis, or to wait until symptoms of the disease appear. The review of trials found that early treatment slows the progression of the disease. However, there is not enough evidence, due to too few studies conducted in patients with early stage myeloma to show that early treatment improves the survival of people with MM.

High‐dose chemotherapy plus single vs tandem autologous transplantation as initial treatment for multiple myeloma

Multiple myeloma is a cancer of antibody‐producing cells in the bone marrow. It causes bone destruction and patients are usually at a higher risk for infections and renal damage. Autologous stem cell transplantation has been established as standard initial treatment for fit patients with symptomatic multiple myeloma. During autologous stem cell transplantation, blood‐forming stem cells are removed from the patient prior to intense chemotherapy and later given back to the same patient. The chemotherapy is aimed at killing tumour cells (the higher the dose the more tumour cells are killed) but also affects normal blood‐forming cells that are needed to fight infections, transport oxygen and control bleeding. By giving the patient back his or her own blood‐forming cells, the recovery from the chemotherapy is notably faster and better. Since it is unclear whether autologous stem cell transplantation as initial treatment of multiple myeloma should be performed once or twice, we systematically searched for publications addressing the question whether the acute toxicity of autologous stem cell transplantation is counterbalanced by a long‐term benefit for the patient. Several studies in which patients undergoing one treatment with autologous stem cell transplantation were compared to patients undergoing autologous stem cell transplantation twice were identified. Only five of 14 studies identified could be analysed in the present systematic review. We were interested in long‐term benefit for patients with respect to overall survival or so called event‐free survival, that is survival without disease progression. Quality of life and treatment‐related mortality should also be analysed in clinical studies.

Bisphosphonates in multiple myeloma

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a B‐cell malignancy or, more precisely, plasma cell neoplasm. This cancer grows inside or outside of bones. The bone damage, or osteolytic lesions, may lead to fractures of the long bones or compression fractures in the spine. The mechanism of bone destruction appears to be related to increased bone resorption by cells called osteoclasts. Bisphosphonates are drugs that can inhibit bone resorption by reducing the number and activity of osteoclasts. This updated review of 20 trials enrolling 6692 patients shows that adding bisphosphonates to myeloma treatment reduces fractures of the vertebra and bone pain. Zoledronate is better than etidronate and placebo alone, but not superior to pamidronate or clodronate for improving overall survival and any other outcomes such as vertebral and nonvertebral fractures.

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Summaries for consumers

Early treatment for early stage multiple myeloma may slow the disease progression but does not appear to improve survival

Multiple myeloma (MM) is cancer of the bone marrow. It causes bone destruction that leads to pain, spinal cord compression and fractures.In early stages, most people do not show any symptoms of MM. It is not clear whether it is better to start treatment with cancer drugs straight after diagnosis, or to wait until symptoms of the disease appear. The review of trials found that early treatment slows the progression of the disease. However, there is not enough evidence, due to too few studies conducted in patients with early stage myeloma to show that early treatment improves the survival of people with MM.

High‐dose chemotherapy plus single vs tandem autologous transplantation as initial treatment for multiple myeloma

Multiple myeloma is a cancer of antibody‐producing cells in the bone marrow. It causes bone destruction and patients are usually at a higher risk for infections and renal damage. Autologous stem cell transplantation has been established as standard initial treatment for fit patients with symptomatic multiple myeloma. During autologous stem cell transplantation, blood‐forming stem cells are removed from the patient prior to intense chemotherapy and later given back to the same patient. The chemotherapy is aimed at killing tumour cells (the higher the dose the more tumour cells are killed) but also affects normal blood‐forming cells that are needed to fight infections, transport oxygen and control bleeding. By giving the patient back his or her own blood‐forming cells, the recovery from the chemotherapy is notably faster and better. Since it is unclear whether autologous stem cell transplantation as initial treatment of multiple myeloma should be performed once or twice, we systematically searched for publications addressing the question whether the acute toxicity of autologous stem cell transplantation is counterbalanced by a long‐term benefit for the patient. Several studies in which patients undergoing one treatment with autologous stem cell transplantation were compared to patients undergoing autologous stem cell transplantation twice were identified. Only five of 14 studies identified could be analysed in the present systematic review. We were interested in long‐term benefit for patients with respect to overall survival or so called event‐free survival, that is survival without disease progression. Quality of life and treatment‐related mortality should also be analysed in clinical studies.

Bisphosphonates in multiple myeloma

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a B‐cell malignancy or, more precisely, plasma cell neoplasm. This cancer grows inside or outside of bones. The bone damage, or osteolytic lesions, may lead to fractures of the long bones or compression fractures in the spine. The mechanism of bone destruction appears to be related to increased bone resorption by cells called osteoclasts. Bisphosphonates are drugs that can inhibit bone resorption by reducing the number and activity of osteoclasts. This updated review of 20 trials enrolling 6692 patients shows that adding bisphosphonates to myeloma treatment reduces fractures of the vertebra and bone pain. Zoledronate is better than etidronate and placebo alone, but not superior to pamidronate or clodronate for improving overall survival and any other outcomes such as vertebral and nonvertebral fractures.

See all (14)

Terms to know

Antibodies
A protein produced by the immune system in response to a foreign substance such as a virus or bacterium.
Bone Marrow
The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.
Lymphocytes
A lymphocyte is a type of white blood cell that is part of the immune system. There are two main types of lymphocytes: B cells and T cells. The B cells produce antibodies that are used to attack invading bacteria, viruses, and toxins. The T cells destroy the body's own cells that have themselves been taken over by viruses or become cancerous.
Plasma Cell Neoplasms
Diseases in which the body makes too many plasma cells. Plasma cell neoplasms can be benign (not cancer) or malignant (cancer).
Plasma Cells
A type of immune cell that makes large amounts of a specific antibody. A plasma cell is a type of white blood cell.
Stem Cells
A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

More about Multiple Myeloma

Photo of an adult

Also called: Kahler's disease, Myeloma, Myelomatosis, Plasmacytic myeloma, Plasma cell myeloma

Other terms to know: See all 6
Antibodies, Bone Marrow, Lymphocytes

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