Multiple Myeloma: Signs, Stages, and Treatment Explained

Multiple myeloma is a condition in which healthy plasma cells become cancerous, multiply and
produce abnormal antibodies called M protein. Plasma cells are a type of white blood cells that make
antibodies to fight infection. With multiple myeloma, plasma cells develop errors and build up in the
bone marrow. It is a rare condition of blood cancer that targets the plasma cells.

Signs and symptoms of multiple myeloma:

The most common symptom is pain in bones (back, head, chest or pelvis). Fatigue and weakness,
frequently falling sick, numbness in limbs, unexplained weight loss, nausea and vomiting are other
signs of multiple myeloma.
While the exact causes of multiple myeloma are medically unclear, the root tends to point towards
some gene mutation in the plasma cells. There are certain risk factors that lead to it:

• Obesity
• Environmental toxins like pesticides or fertilisers
• Multiple myeloma affects more males than females and more common in middle to old age
  group people
• Family history of multiple myeloma

Stages of multiple myeloma:

Multiple myeloma is staged between 1 to 3, depending upon the aggressiveness and severity of the
disease. The stage is determined by blood tests (beta-2 microglobulin, albumin, LDH), chromosome
analysis, and imaging in patients. This is to assess the burden of tumour present. Higher stages
indicate more aggressive and rapid growth of cancer cells.
Stage 1 is categorised with lower levels of beta-2 microglobulin and relatively normal albumin levels,
indicating a slower growth
Stage 2 has intermediate levels of beta-2 microglobulin and lower albumin levels
Stage 3 has higher levels of beta-2 microglobulin which indicates that the growth is rapid and disease
has become aggressive. This calls for an immediate intervention
Several tests are conducted to diagnose multiple myeloma and asses what stage the patient is at –

• Blood tests are done to check for lower blood count or presence of abnormal antibodies like
  M protein. They may also indicate any signs of tumour
• High levels of protein in urine is also an indicator of multiple myeloma, hence urine tests also
  become important
• Imaging tests such as X-rays, CT scan, MRI, PET scan can also reveal tumours or abnormal
  plasma cells
• Bone marrow biopsy is conducted to test the bone marrow tissue and check for signs of
  myeloma

Treatment of multiple myeloma

Once the results from these tests arrive and the oncologist determines the stage of multiple
myeloma, treatment procedures and planned and mapped out –

1. Stem cell transplant – Damaged and unhealthy stem cell tissues are replaced with healthy
   ones. Stem cells enable the production of healthy new plasma cells in the bone marrow.
2. Chemotherapy is a drug-induced therapy that reduce the abnormal plasma cells. It is often
   done before stem cell transplant for an effective result. Radiation in addition with
   chemotherapy kills cancer cells
3. Immunotherapy helps the immune system develop more cancer-fighting cells
4. Targeted therapy targets specific weakness in plasma cells and kills them
5. High doses of steroids can also kill cancer cells and reduce inflammation

Yashoda Superspeciality Hospital & Cancer Institutes, Sanjay Nagar, Ghaziabad, has a highly-skilled
network of oncologists to treat patients with multiple myeloma.

Dr. (Maj. Gen.) B.N. Kapur, the Director of Medical Oncology at Yashoda Superspeciality Hospital &
Cancer Institutes, is one of the best oncologists in Delhi NCR. Former Indian Army Medical
Oncologist, he is a recipient of the Vishisht Sewa Medal (VSM), an accolade for his dedicated services
which he received from the President of India. Dr. (Maj. Gen.) B.N. Kapur specialises in bone marrow
transplant, hematolymphoid malignancy, paediatric tumour, and all solid tumours including all kinds
of blood cancers. He is also skilled in treating solid organ cancers using latest evidence-based
therapies and has a number of publications in his name.

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