Multiple Myeloma

About Multiple Myeloma

Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Produced in the bone marrow, healthy plasma cells fight infections by making antibodies that recognize and attack foreign invaders (pathogens). When cancerous plasma cells known as myeloma cells accumulate in the bone marrow, they crowd out healthy blood cells, creating more abnormal proteins than helpful antibodies. This leads to complications including bone problems, reduced kidney function, severe anemia, recurrent life-threatening infections, and more.

The symptomatic form of multiple myeloma is known as active multiple myeloma, a cancerous stage linked to damage to red blood cells, kidneys, and/or bones Myeloma progresses through two asymptomatic precursor stages before reaching this active state. The first, known as monoclonal gammopathy of undetermined significance (MGUS), is associated with low levels of abnormal proteins in the blood and malignant plasma cells in the bone marrow. The second stage, smoldering multiple myeloma (SMM), is characterized by higher abnormal protein and plasma levels than in MGUS and a lack of symptoms. Not all people with MGUS or SMM go on to develop active multiple myeloma.

While multiple myeloma is not a common cancer, it is the second most common blood cancer diagnosis. The American Cancer Society estimates that over 35,000 patients in the United States will be diagnosed with multiple myeloma in 2023. Treatment isn’t always necessary for patients who aren’t experiencing symptoms; however, for those patients who do require treatment, it is best managed by a hematologic malignancies specialist.

Types of Multiple Myeloma:

Multiple myeloma is classified based on the type of immunoglobulin (protein) produced by myeloma cells (malignant plasma cells). Immunoglobulin molecules combine two heavy chain fragments (IgG, IgA, IgD, IgE, or IgM) and two light chain fragments (kappa or lambda).

Types of multiple myeloma include:

• IgA kappa or lambda myeloma: Forms of the condition in which myeloma cells secrete an immunoglobulin combining an IgA heavy chain and a kappa or lambda light chain.
• IgD kappa or lambda myeloma: Forms of the condition in which myeloma cells secrete an immunoglobulin combining an IgD heavy chain and a kappa or lambda light chain.
• IgE kappa or lambda myeloma: Forms of the condition in which myeloma cells secrete an immunoglobulin combining an IgE heavy chain and a kappa or lambda light chain.
• IgG kappa myeloma: The most common form of the condition, in which myeloma cells secrete an immunoglobulin combining an IgG heavy chain and a kappa light chain.
• IgG lambda myeloma: Forms of the condition in which myeloma cells secrete an immunoglobulin combining an IgG heavy chain and a lambda light chain.
• IgM kappa or lambda myeloma: Rare forms of the condition linked to Waldenström macroglobulinemia in which myeloma cells secrete an immunoglobulin combining an IgM heavy chain and a kappa or lambda light chain.
• Light chain myeloma: The second most common form of the condition in which myeloma cells secrete light chain fragments only.
• Non-secretory myeloma: A form of the condition in which myeloma cells secrete little to no abnormal immunoglobulin proteins.

Symptoms of Multiple Myeloma

Early multiple myeloma rarely causes symptoms.

Symptoms of multiple myeloma may include:

• Bone pain, especially in the spine or chest
• Constipation
• Drowsiness
• Excessive thirst
• Fatigue
• Frequent infection
• Kidney problems
• Loss of appetite
• Mental fogginess or confusion
• Nausea
• Unintended weight loss
• Weakness or numbness in the legs

Risk Factors for Multiple Myeloma

Certain people are at greater risk for multiple myeloma.

Risk factors for multiple myeloma may include:

• Age: Though multiple myeloma can occur at any age, the condition usually affects those over the age of 65.
• Family history: A family of multiple myeloma increases your risk for the condition, and African Americans twice as likely to develop multiple myeloma than white Americans.
• Health history: Multiple myeloma is associated with a history of other plasma cell diseases, such as solitary plasmacytoma, as well as exposure to chemotherapy and radiation.
• Personal history: Obesity and exposure to chemicals such as benzene and pesticides have been linked to multiple myeloma.
• Sex: Men are more likely to be diagnosed with multiple myeloma than women.

Treating Multiple Myeloma at UT Health Austin

Treatment will require an accurate diagnosis and depend on disease progression. Your care team will work with you to develop a treatment plan tailored to your individual needs. Treatment options may include a combination of radiation therapy, immunotherapy, chemotherapy, and/or stem cell transplant.

Care Team Approach

At UT Health Austin, we take a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines caring for you in one place to avoid having to schedule multiple appointments with providers at locations all over the city. The Livestrong Cancer Institutes care team includes medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists, oncofertility specialists, onco-psychiatrists, genetic counselors, physical therapists, dietitians, social workers, and more as well as other members of the CaLM Care Team who work together to help you get back to the things in your life that matter most to you.

We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to provide you with state-of-the-art care. We call our approach to cancer care CaLM (Cancer Life reiMagined), and your treatment begins with a comprehensive, whole-person assessment that your care team will use to develop a personalized care plan to treat your condition and help restore your wellness. The CaLM approach also includes coordinated, whole-person services, such as relaxation and stress reduction strategies, nutritional guidance, financial planning, and emotional support, that can make a real difference for you and your family. Advanced imaging and lab testing are also available on-site if needed.

Learn More About Your Care Team