What is multiple myeloma?

Multiple myeloma (MM) is a B-cell malignancy in which abnormal, clonal plasma cells proliferate and accumulate in the bone marrow. Myeloma cells disrupt normal bone marrow function and invade the surrounding bone causing bone destruction.5 The interactions between myeloma cells and stromal cells in a specialized niche in the bone marrow facilitate cell growth and disease progression, which can lead to anemia, thrombocytopenia, bone disease, hypercalcemia and renal impairment.5-7

Myeloma cells typically harbor one or more mutations in the genes responsible for immunoglobulin production. Additional mutations can develop in a clonal fashion, resulting in a heterogeneic population of myeloma cells in the bone marrow.8 Myeloma cells produce and secrete significant quantities of the abnormal antibody component, monoclonal protein (M-protein). Excess production of M-protein causes accumulation in the bone marrow and subsequently the bloodstream followed by the urine. In addition, abnormal monoclonal molecules can adhere to each other and/or other tissues such as blood cells, blood vessel walls, and other blood components, which can reduce blood flow and circulation.3

Symptoms that patients may experience9,10

Bone problems

Mental fogginess or confusion


Frequent infections

Excessive thirst

Loss of appetite and weight loss


Nausea and vomiting

Key statistics about multiple myeloma

Multiple myeloma is the second most common blood cancer, with close to 176,000 new cases diagnosed globally per year.1,2 Despite increased availability of novel agents, the disease is characterized by a pattern of recurrent relapses and remains incurable for the majority of patients, leading to approximately 117,000 deaths per year, worldwide.2,11,12

In the United States, it is estimated that in 2021 there will be approximately 34,920 new cases of myeloma and an estimated 12,410 deaths from this disease.1


most common

Risk factors


Multiple myeloma is most common in people between 65-743,4


Multiple myeloma is slightly more common in men than women4


African Americans are twice as likely to develop multiple myeloma as White Americans3


Although this only accounts for a small number of cases, someone with a sibling or parent with multiple myeloma is more likely to develop the disease than someone who has no family history4

For patients interested in learning more about multiple myeloma, please visit http://www.myelomaexplained.com

Multiple myeloma stages5

The stages of multiple myeloma

The stages of multiple myeloma are defined as asymptomatic or symptomatic/active disease according to the guidelines set by the International Myeloma Working Group (IMWG).13 Monoclonal Gammopathy of Undetermined Significance (MGUS) display M-protein less than 3.0 g/dL and bone marrow clonal plasma cells less than 10%. Smoldering multiple myeloma display M-protein greater than 3.0 g/dL and bone marrow clonal plasma cells between 10% and 60%. Symptomatic/active multiple myeloma is characterized by the presence of M-protein, greater than 60% bone marrow clonal plasma cells, and indicators of organ damage classified by the CRAB criteria. CRAB features include Calcium elevation, Renal dysfunction, Anemia, and Bone disease.5

CRAB criteria are used to help identify Multiple Myeloma. Myeloma is defined by the presence of monoclonal protein and one or more CRAB features and/or indicators of organ damage:5

Name Definition
C Calcium elevation (> 10mg/dL)
R Renal dysfunction (creatinine > 2mg/dL or creatinine clearance < 40mL/min)
A Anemia (hemoglobin < 10g/dL or > 2g/dL decrease from patient’s normal)
B Bone disease (one or more osteolytic lesions detected on skeletal radiography, whole body low dose CT, or PET/CT)