Flowing through your body, you have a well-orchestrated balance of cells in your blood that keep your body functioning at its best. Responding to your body's every move, your blood cells quickly adjust to provide adequate oxygen and nutrients to each of your body's cells, carry waste products away, and help you to ward off or heal illness and injury.
In health, this perfect equilibrium between the body's needs and the production of specific blood cells keeps you healthy and well. But sometimes, and often for reasons unknown, there is a disruption to normal blood cell production. This is the case with a particular blood cancer that we're going to discuss called multiple myeloma.
We'll explain what multiple myeloma is as well as some exciting treatments that are providing hope to those affected by this disease.
Multiple Myeloma Basics
Bone marrow is found in the hollow of ones long bones. The stem cells that give birth to other types of blood cells live in the bone marrow. There are three main types of blood cells - white blood cells, red blood cells and platelets. While each person has the same red cells and platelets, there are many different types of white blood cells, one of which is called the plasma cell.
It's important to understand what plasma cells do each plasma cell makes a special protein called an antibody that targets a specific foreign object (like bacteria, viruses or fungus) to protect our bodies.
Multiple myeloma is a cancer formed by malignant plasma cells. It is the third most common blood cancer in the U.S. and makes up about 1.4 percent of new cancer diagnoses. When a group (or clone) of plasma cells become cancerous, they erratically divide and multiply, creating extra proteins in the blood that affect the balance of the other blood cells production.
With multiple myeloma, hemoglobin can go down, blood calcium levels can rise to dangerous levels, bone fractures may occur and kidney function can decline.
Symptoms of Multiple Myeloma
There are three distinct phases of multiple myeloma, which define how the disease progresses and the symptoms that present. It's important to know that having a few cancerous plasma cells doesn't mean patient has myeloma or needs treatment. In fact, some patients in the first phase of multiple myeloma can go years without monitoring or treatment.
Multiple myeloma can be diagnosed in several different ways. In earlier stages, a patient's routine lab work, as part of their annual physical, could pick up on some blood cell protein abnormalities. In more advanced phases of the disease, bone pain, excessive tiredness or kidney problems could be the first indicators.
While multiple myeloma tends to be a disease that mainly affects the elderly and does have some ethnic variations, this disease does not have an identified cause or specific risk factors.
Treatment for Multiple Myeloma
Even though multiple myeloma is not curable, it is controllable and many new treatments have been developed or are on the horizon.
As a result of improved treatments, survival of patients with multiple myeloma is most often measured in years, not months. The quality and duration of life with multiple myeloma is much improved, possibly ten years or more.
Think of multiple myeloma as an iceberg. If it stays under the surface of water, it doesn't harm the body. If it rises above the water's surface, it can become harmful to the body and needs treatment.
Treatment often starts with four to six cycles of induction chemotherapy, which is usually about three different medications. Chemotherapy can help chop the iceberg down under the water's surface, but it can't keep it there, so induction chemotherapy should be followed by with an autologous stem cell transplant.
An autologous stem cell transplant is part of the current standard of care for multiple myeloma. For an autologous transplant, the patient's own cells are used, eliminating the chance of rejection and lowering the mortality rate to less than a one percent.
And even better, most patients see positive outcomes with little complications after the transplant, which requires a hospital stay of two weeks or less.
This transplant chops the iceberg all the way to bottom; while we can't get rid of it entirely, it takes longer to grow back and come above water.
Beyond the transplant, maintenance chemotherapy might be needed, which uses medicine at half or a third of traditional chemotherapy doses. This is often provided in the form of a pill that patients can take at home with the goal to slow the growth of myeloma in the body after the transplant.
Sometimes, a second transplant can be a treatment option if a relapse occurs 18 to 24 months after the first one.
New Hope for Multiple Myeloma
There are two antibody-based treatments that specifically try to target the proteins on the plasma cells in order to control the myeloma. Another promising treatment in early clinical trials is CAR T cell treatment, which uses the patients own immune power to control cancerous plasma cell growth.
At AdventHealth, we're on the forefront of new treatments that use the patient's own immune system to treat cancer, including using immune modulated agents that can target cancerous plasma cells and essentially shut down their production and eliminate them.
Our treatments have moved away from high toxicity chemotherapy and toward well-designed, purposeful medicines that do specific jobs with fewer side effects.
AdventHealth is a place full of hope. We strive to be the best as a medical team and provide the best possible care to help our patients heal every step of the way.
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