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At Boston Medical Center (BMC), the care of patients with multiple myeloma is a collaborative, multidisciplinary process. BMC’s Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits. The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling cancer, while managing its impact on quality of life.

As the primary teaching affiliate of the Boston University School of Medicine, BMC combines personal, patient-focused care with the state-of-the-art-expertise and technological advances of a major teaching hospital. BMC is at the forefront of clinical practice, surgical expertise, and research in oncology.

To schedule an appointment or refer a patient, call 617.638.6428. Patients with a diagnosis or strong suspicion of cancer are given appointments within 72 hours.

What Is Multiple Myeloma?

Multiple myeloma is a cancer of the bone marrow arising from plasma cells, which are part of the immune system.

There are red blood cells, white blood cells, and platelets. White blood cells help the immune system fight infection. Plasma cells are white blood cells that produce antibodies: proteins that help the immune system protect the body from infection. Plasma cells produce antibodies in response to foreign substances (called antigens) entering the body. Different antibodies bind to different antigens to help destroy them. Some antibodies are able to destroy antigens on their own, whereas others assist other white blood cells in destroying them.

Myeloma begins when a plasma cell becomes abnormal and begins to divide uncontrollably, producing large numbers of these abnormal cells. These abnormal plasma cells are myeloma cells, and they divide out of control and do not die when they should. The cancer cells then accumulate and form a tumor.

A single tumor is called an isolated (or solitary) plasmacytoma. When there are several tumors present, the disease is referred to as multiple myeloma.

A shortage of red blood cells, white blood cells, and/or platelets may result when too many myeloma cells are present in the bone marrow. This can lead to a number of health issues, such as anemia (a shortage of red blood cells, which can cause pallor and fatigue), leukopenia (a shortage of white blood cells, which makes it difficult for the body to fight infection), and bruising or bleeding (caused by a shortage of platelets, which control bleeding).

Myeloma cells also interfere with bone maintenance. Normally, groups of cells work together to maintain proper bone shape and health. Certain groups of cells build bones up, while others break them down. Myeloma cells cause too much bone to break down and not enough replacement bone to be made. Bones then become weak and break easily. Because myeloma causes so much bone to be broken down, it often causes calcium levels in the blood to rise, causing tiredness and weakness.

Symptoms of Multiple Myeloma

The most common symptoms of multiple myeloma include

  • Bone pain, usually in the back or spine
  • Broken bones, usually in the spine
  • Feeling weak and very tired (also called fatigue)
  • Frequent infections and fevers
  • Frequent urination
  • High levels of calcium in the blood
  • Low blood counts
  • Nausea or constipation
  • Weight loss

These symptoms can occur from health issues other than cancer, so it’s important that anyone experiencing these symptoms be seen by a physician.

Causes of Multiple Myeloma

Although the exact causes of multiple myeloma remain unknown, certain risk factors—things that increase an individual's chances of developing cancer—have been identified. While risk factors may be useful in identifying high-risk individuals, they do not determine whether a person develops a disease. Some risk factors, such as diet, are within a person’s control, whereas others, such as age, are not.

Some possible risk factors for multiple myeloma include

  • Age: A person’s chances of developing multiple myeloma increase with age. Few people develop the disease before age 65.
  • Gender: Men have a higher risk of developing multiple myeloma than women. The reason why is unknown.
  • Race: African Americans have the highest risk of developing the disease.
  • Personal history of monoclonal gammopathy of undetermined significance (MGUS): MGUS is a benign (noncancerous) condition. For people who have it, it means abnormal plasma cells are present and producing M proteins. There are generally no symptoms associated with MGUS, and it is usually found with a blood test, the results of which indicate a high level of M protein in the blood. People with MGUS may develop certain cancers, including multiple myeloma. MGUS is not a treatable condition. For those with MGUS, physicians recommend regular lab testing (every 6 to 12 months) to monitor the level of M protein in the blood and regular exams to check for symptom development.
  • Family history: A person’s risk of developing multiple myeloma is higher if that person has a close relative with the disease. Not having a family history of the disease in no way guarantees a person will not get it.
  • Obesity: According to a study by the American Cancer Society, people who are overweight or obese have an increased risk of developing multiple myeloma (American Cancer Society 2015a).
  • Radiation: Exposure to lower levels of radiation can also increase a person’s risk of developing the disease, but very few cases of the disease result from this kind of exposure.

Other possible risk factors currently under study include gene mutations (changes in the DNA sequence of a gene), eating certain foods, and exposure to certain chemicals or germs (viruses in particular).

References

American Cancer Society. 2015a. Detailed Guide: Multiple Myeloma. PDF.

-----. 2015b. Overview Guide: Multiple Myeloma Overview. PDF.

Millennium Pharmaceuticals, Inc. 2011.Understanding Multiple Myeloma. Houston: Phyllis Pittman Communications, LTD.

National Cancer Institute. 2008. What You Need To Know About™ Multiple Myeloma. PDF. Bethesda: National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services.http://www.cancer.gov/

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