Multiple Myeloma is a type of blood cancer that affects the plasma cells. Plasma cells are immune cells that normally make special proteins, called antibodies, to fight off disease. These antibodies are part of the body’s defense system to neutralize infections that invade the blood stream.
The tubules are the pipes through which filtered blood ultimately becomes urine and exits the body as waste. The kidney has many filters, which we call glomeruli. The blood passes through the glomeruli and then enters the tubules (pipes). The abnormal proteins that are made by the plasma cells in patients with multiple myeloma float around in the blood stream. The blood passes through the filters in the kidneys and these abnormal proteins enter the tubules. These abnormal proteins then travel through the tubules and can join up with another type of protein normally present in the urine, Tamm Horsfall protein. If these two proteins join together they become too big to pass on through the tubules and therefore cannot exit the kidney in the form of urine. This combination of proteins results in large casts that block the tubules inside the kidney. These tubules are just like pipes that carry water, when they get blocked fluid cannot flow through. These blockages lead to kidney damage.
In addition to blockages, these casts cause an inflammatory reaction in the tissue of the kidney around them. When kidney failure occurs due to these blockages, we call this cast nephropathy or myeloma kidney.
The tubules of the kidney can also be damaged simply due to the toxic effects of these filtered proteins. This can lead to abnormal kidney function even in the absence of cast formation. However, myeloma kidney is by far the most common manifestation of kidney disease in patients with multiple myeloma.
Malignant plasma cell production interferes with the production of normal red and white blood cells. Anemia occurs when the red blood cell count is low. It can cause fatigue, shortness of breath, and dizziness. About 60 percent of people with myeloma experience anemia, according to the MMRF.
White blood cells fight infection in the body. They recognize and attack harmful germs that cause disease. Large numbers of cancerous plasma cells in the bone marrow result in low numbers of normal white blood cells. This leaves the body vulnerable to infection.
Abnormal antibodies produced by cancerous cells do not help to fight infection. And they can also overtake healthy antibodies, resulting in a more weakened immune system.
Bone loss from myeloma causes an excess of calcium to be released into the bloodstream. People with bone tumors are at an increased risk of developing hypercalcemia. Hypercalcemia can also be caused by overactive parathyroid glands.
The diagnosis of multiple myeloma is determined by a number of different diagnostic tests, because myeloma is difficult to diagnose on the basis of any single laboratory test result. Accurate diagnosis generally results from consideration of several factors, including physical evaluation, patient history, symptoms, and diagnostic testing results. The initial evaluation to help confirm a diagnosis of myeloma includes blood and urine tests as well as a bone marrow biopsy. Other tests include X-rays. MRIs, CT scans and PET scans.
After multiple myeloma is found and staged, your cancer care team will discuss treatment options with you. The treatment for multiple myeloma may include:
It is important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs.
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.