Here’s how this cancer of plasma cells develops.
When you think of a blood cancer, you may automatically think it’s a type of cancer that affects that red stuff coursing through your veins. While that’s not completely incorrect, blood is far more complex than what meets the eye. There are actually many different types of blood cancer that affect different microscopic parts of the blood.
One of these blood cancers is called multiple myeloma. Multiple myeloma is a cancer of the plasma cell, which is a type of white blood cell. These cells live in the bone marrow and are key for healthy immune system function. Normally, those white blood cells make antibodies to help fight off infection.
“In myeloma, [the plasma cells] misbehave and start making an antibody that’s completely useless,” says Adriana Rossi, MD, associate clinical director of the Myeloma Center at Weill Cornell Medicine and NewYork-Presbyterian.
This abnormal antibody, called M protein, floats around and can be toxic to kidneys or attack other parts of the body. In fact, the hallmark characteristic of multiple myeloma is a high level of M protein in the blood.
“So instead of helping you fight an infection, the [abnormal plasma cells] just sort of accumulate,” says Dr. Rossi. These “misbehaving” cells then crowd out the normal, infection-fighting plasma cells, which can lead to low blood counts and low immune cells, increasing the risk of infections and other multiple myeloma complications.
What’s more, because the tumor cells are in the bone marrow, they can affect regular bone marrow function and cause damage to the bones.
Diagnosing Multiple Myeloma
Catching multiple myeloma early can be difficult. By the time most people experience multiple myeloma symptoms, such as fatigue or bone pain, the disease has likely progressed to an advanced stage.
Multiple myeloma is often caught during a routine blood test. “[Myeloma] starts off with the presence of the abnormal antibody and leads to a referral to a hematologist for a complete testing,” says Dr. Rossi.
If a doctor suspects multiple myeloma, they may conduct imaging tests (such as an MRI or CT scan), a urine sample to assess a patient’s kidney function and the presence of the M protein, or a bone marrow biopsy to get a sample of the tissue.
If a multiple myeloma diagnosis is confirmed, your doctor will discuss your treatment options. “It's a great time to be treating myeloma because we've had so many advances in recent years,” says Dr. Rossi. “So, even though myeloma is considered incurable, right now we try to get you into remission and then make it last as long as possible, which for many patients is years.”
Adriana Rossi, MD, is the Associate Clinical Director of the Myeloma Center at Weill Cornell Medicine and NewYork-Presbyterian.
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Myeloma is a cancer of the bone marrow and
affects both normal bone marrow function.
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It can damage bones and also the kidneys.
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The cancer cells are located
in the bone marrow and
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so plasma cells in your bone
marrow are part of your immune
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system that help you fight
infections by making antibodies.
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And in myeloma, they misbehave and
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start making an antibody
that is completely useless.
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So instead of helping you fight an
infection, they just sort of accumulate.
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So you accumulate cells in your
bone marrow that crowd out
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the normal blood cells.
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So you can have low blood counts or
low immune cells,
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increasing the risk for infections.
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And this antibody that it's making floats
around and can be toxic to kidneys or
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attack other parts of the body.
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So abnormal plasma cells are myeloma.
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Myeloma is a cancer of plasma cells.
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So in the normal immune system, you have
healthy plasma cells making useful and
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In myeloma, you have these malignant
cells making a useless antibody that can
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actually cause damage.
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So, even though myeloma is
considered incurable right now,
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we try to get you into remission and
it's a great time to be treating myeloma.
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Because we've had so
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many advances in recent years that really
the entire paradigm has been changing.
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And regardless of whether or not you've
had a transplant, once you get into your
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first remission, we have continuous
therapy to keep you in remission.
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And then make it last as long as possible,
which for many patients is years.
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Plasma Cell Neoplasms (Including Multiple Myeloma)—Patient Version. The National Cancer Institute. (Accessed on June 24, 2019 at https://www.cancer.gov/types/myeloma)
Multiple Myeloma Symptoms, Diagnosis, and Staging. UpToDate. (Accessed on June 24, 2019 at https://www.uptodate.com/contents/multiple-myeloma-symptoms-diagnosis-and-staging-beyond-the-basics)
What Is Multiple Myeloma? American Cancer Society. (Accessed on June 24, 2019 at https://www.cancer.org/cancer/multiple-myeloma/about/what-is-multiple-myeloma.html)