It is the cancer of plasma cells. These are the cell responsible for providing immunity in the body.
What are the Symptoms?
Fatigue can be seen due to decreased hemoglobin. Recurrent infections occur due to decreased WBC and bodyaches especially back pain. In late stages these can have paralysis, kidney failure, seizures etc.
What is the cause of Myeloma?
Cause is mostly unidentified. It is thought to be secondary to some mutations in the body.
What are the stages of Myeloma?
- MGUS these are initial stages and will evolve into Multiple Myeloma
- Smoldering myeloma
- Multiple Myeloma usually affects our immune system, kidneys and bones
How is it diagnosed?
It is diagnosed with the help of a bone marrow test which shows increase in cancer cells. Other blood tests help in identifying increased level of cancer proteins in the body. Measurement of calcium, hemoglobin kidney function test and total body scanning are also important.
What is the risk characterization?
Based on the genetic mutations Albumin, LDH and beta-2microglobulin levels these cancers can be divided in favorable risk, intermediate risk and high risk disease.
Why is risk characterization necessary?
Risk category determines the likely outcome of any treatment in the patient i.e. the chances of cure.
- In Favorable risk chances are around 90% response rates and in poor risk chances of relapse are as high as 80%
What happens if the patient is not treated?
These patients can have recurrent symptoms of fatigue, infection, kidney failure and fractures. Rarely the infections can be so severe so as to cost the life of the patient.
What is the treatment?
Treatment options depend on the tolerability of the patients
- Initially patients are divided into two types, those who can tolerate the treatment and those who cannot.
- Transplant eligible patients are given 4-6 cycles of chemotherapy and then taken for transplant
- Transplant ineligible patients are given 9-12 cycles of chemotherapy and then kept on Maintenance
Why Transplant when the patient can be treated with only chemotherapy?
Transplant offers better control of disease. Thus these patients have longer disease free time with transplant, preserving the quality of life of these patients.
Can I do transplant if my disease comes back
Transplant can be offered when the disease relapses, however the fitness of the patient declines when the disease relapses and they may no longer be able to tolerate the transplant. These patients may have lost the chance to the best possible treatment by then.