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
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
2nd
most common
hematologic
malignancy.1,2
Risk factors
AGE
|
Multiple myeloma is most common in people between 65-743,4
|
GENDER
|
Multiple myeloma is slightly more common in men than women4
|
RACE
|
African Americans are twice as likely to develop multiple myeloma as
White Americans3
|
FAMILY
HISTORY
|
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 are defined as asymptomatic or
symptomatic/active disease according to the guidelines set by the .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) |