Multiple myeloma

Diagnosis

Routine blood test results could help the physician identify if the patient have a multiple myeloma, however it may require further testing for proper diagnosis.

• Complete blood count: to check for abnormalities in red blood cells, white blood cells count, and platelets.
• Blood test: patient’s blood may be analyzed in a lab to look for M proteins made by myeloma cells. Beta-2-microglobulin is a different abnormal protein made by myeloma cells that may be found in the blood and provide the specialist with information about how aggressive the myeloma. Blood tests to check your calcium levels, uric acid levels, and kidney function can also provide your doctor with information on your diagnosis.
• Urinalysis: urine analysis may reveal M proteins, also known as Bence Jones proteins when they are found in urine
• Bone marrow biopsy and aspiration: A long, thin needle is inserted into the bone marrow (commonly at the pelvic bone) to aspirate fluid during the procedure, then the sample is sent to laboratory for testing to determine the percentage of abnormal cells. A test called fluorescence in situ hybridization (FISH) will be used to analyze myeloma cells to identify gene mutations.
• Imaging test: To identify bone issues brought on by multiple myeloma, imaging studies will be recommended. An MRI, CT, positron emission tomography (PET), or an X-ray are examples of possible tests.

Staging

After the diagnosis of the multiple myeloma is confirmed, staging will be used to identify the extent of the cancer. The stages of cancer are indicated by Roman numerals ranging from I to III. The lowest stage indicates that the disease is less aggressive and the highest stage – stage III – indicates that the disease is most aggressive.
The staging will help the specialist to provide the most appropriate treatment.

Treatment

Treatment can improve symptom-related discomfort, manage disease complications, stabilize your condition, and slow the spread of multiple myeloma

There may be no need for immediate treatment. Smoldering multiple myeloma, which is characterized by the absence of symptoms in multiple myeloma, may not require immediate medical attention. If multiple myeloma is diagnosed early and is slow-growing, immediate treatment might not be required. Even so, the specialist will have regular checkup with the patient to look for symptoms of a developing disease. Regular blood and urine tests may be required for this.

The specialist and the patient may plan out and may decide to start treatment if the patient exhibit symptoms or if the multiple myeloma demonstrates indicators of progression.

• Targeted therapy – focuses on a specific part of the cancer cells by focusing on the weaknesses of the cells and therefore blocking the abnormalities. The therapy cause cancer cells to die.
• Immunotherapy – will help the immune system fight the cancer by boosting the immune system.
• Chemotherapy – uses drugs to kill cancer cell. Prior to bone marrow transplant, higher dose of chemotherapy drugs are given to kill the cancer cells.
• Steroids/ Corticosteroid – will help kill the cancer cells and prevent or reduce inflammation in the body.
• Bone marrow transplant (stem cell transplant) – will replace the bone marrow with healthy stems cells that will help in the formation of healthy bone marrow.
• Radiation therapy – High-powered energy beams from sources like X-rays and protons are used in radiation treatment to kill cancer cells. When a group of abnormal plasma cells forms a tumor (plasmacytoma) that is inflicting pain or damaging bones, it may be used to rapidly shrink myeloma cells in that location.