The Cause of Multiple Myeloma

Multiple myeloma (also plasma cell myeloma also known as MM, myeloma, plasma cell myeloma, or as Kahler's disease) is a progressive hematologic (blood) disease. It is a cancer of the plasma cell, an important part of the immune system that produces immunoglobulins (antibodies) to help fight infection and disease.

The diagnosis of multiple myeloma can occur after a routine blood test with your doctor. However, the most common diagnosis occurs when doctors take an x-ray of a broken bone and suspect the cancer has caused or is a contributing factor to the broken bone. When analyzing the blood tests, the following are considered when diagnosing multiple myeloma: people with multiple myeloma have high levels of proteins in the blood, especially M and other immunoglobulin, albumin, and beta-2-microglobulin. Also, the blood exam tests for high levels of calcium and for creatinine levels (to assure that the kidneys are working properly).3 Other ways to test for multiple myeloma include urine tests, x-rays, biopsies (test the bone marrow itself from a large bone - a painful procedure). Unfortunately, Multiple myeloma is a very fatal cancer, where only 35% of patients diagnosed with multiple myeloma living 5 years past their diagnosis.3

Leukemia is a cancer of blood cells, specifically white blood cells that are responsible for fighting infection. However, the abnormal cells in leukemia do not function in the same way as normal white blood cells. Leukemia cells continue to grow and divide, eventually crowding out normal blood cells. The end result is that it becomes difficult for the body to fight infections, control bleeding and transport oxygen (Medicine Net, 2015). It is estimated that each year, approximately 30,800 individuals will be diagnosed with leukemia in the United

Mr. Jacobs is a very pleasant, 69-year-old gentleman who presents to the oncology clinic for evaluation and treatment of a myelodysplastic syndrome with excess blasts in transformation RAEB-2. Patient states he was in a normal state of health until 01/2017 when he was evaluated to have anemia and leukopenia. He was referred to a hematologist/oncologist and underwent a bone marrow biopsy. The results revealed a mild dysplastic syndrome with excess blasts in transformation RAEB-2. Flow cytometry showed 11% myeloblasts. He was subsequently given one unit of packed red blood cells and started on erythropoietin every three weeks

Myelodysplastic syndrome is caused when blood forming cells in the bone marrow are damaged, so in this case Myelodysplastic syndrome is not contagious. There are different types of treatment, chemotherapy or a bone marrow transplant. Chemotherapy can be orally taken or injected into the bloodstream. Like all treatments there are various side effects such as loss of hair, loss in appetite, drowsiness, lack of taste, nausea, and a weak immune system. Once the person is diagnosed and finds out how severe their diagnosis is, they are immediately treated to prevent the syndrome from getting worse (Elaine 51). To prevent the syndrome or try to help the syndrome, try exercising more and eating healthier. Exercising and eating a healthy diet helps reduce fatigue and drowsiness. Also, not smoking lowers your risk of getting diagnosed with this syndrome (Elaine 77).

Multiple myeloma (MM) is a rare life-threatening cancer that affects the white blood cells known as plasma cells that are found in the soft, spongy tissue at the center of the bones, called bone marrow. The plasma cells are useful in fighting infections by producing antibodies that recognize and attack germs. The plasma cells are transformed into malignant myeloma cells when there are high levels of M proteins or better known as the production of abnormal antibodies from a result of myeloma cells. These M proteins multiple and block out normally functioning antibodies and the end results are bone damage or kidney problems. An individual can have blood tests or urine tests done to determine if they have multiple myeloma. In the article, “The work of living with a rare cancer: multiple myeloma” the authors explain how this type of cancer still remains incurable, but treatable that patients can expect to live longer, approximately five to seven years than what two decades ago. This was not expected for patients diagnosed with multiple myeloma during the 1990s, since patients were expected to only live about two and a half years after being diagnosed. Treatment for multiple myeloma throughout the years has advanced greatly yet a cure is still to be discovered. This essay will focus of the causes, the sign and symptoms, how multiple myeloma is detected and diagnosed, and how multiple myeloma is treated.

Myelodysplastic disorders (MDS) are conditions that happen when the blood-forming cells within the bone marrow are harmed. This harm prompts low quantities of one or more sorts of platelets. Myelodysplastic syndromes (MDS) are a group of diseases of the blood characterized by a defect in the bone marrow that produces abnormally or insufficient blood red, blood cells white and platelets. MDS is also called pre-leukemia because, over time, can develop into leukemia become acute and should not be confused with Myeloproliferative syndromes.

Blood protein testing: A test to examine various proteins in the blood can aid in detecting certain abnormal immune system proteins that are sometimes elevated in people with multiple myeloma ("Leukemia Home Page - National Cancer Institute").

Terpos, E., Dimopoulos, M. A., Sezer, O., Roodman, D., Abildgaard, N., Vescio, R., & ... Durie, B. M. (2010). The use of biochemical markers of bone remodeling in multiple myeloma: a report of the International Myeloma Working Group. Leukemia (08876924), 24(10), 1700-1712. doi:10.1038/leu.2010.173

This study explores the prevalence, role, and suppressive properties of T regulatory cells (Treg) in multiple myeloma (MM) patients as compared to healthy individuals. This is accomplished by analyzing peripheral blood and bone marrow Treg cells of premalignant and malignant MM patients with the use of flow cytometry. Treg, CD4 T, and lymphocyte cells in MM patients and healthy volunteers are also evaluated for their suppressive property. This was accomplished by testing effects of cyclophosphamide, thalidomide plus dexamethasone (CTD) upon cells, before and after treatment. A total of 25 patients were analyzed in this study. The results showed elevated frequencies of Treg cells in newly diagnosed and relapsed MM patients as compared to healthy volunteers. The proportion of naive and activated Treg cells were also higher in MM patients than healthy volunteers. Functional studies demonstrated no significance of inhibitory function between MM patients and healthy volunteers. There was, however, significant increases of Treg cells with clinically adverse effects (ie. hypercalemia, low normal plasma cell count, and IgA myeloma subtype) in MM patients as compared to the control. It was also observed that MM patients with ≥5% of Treg cells had inferior time to progression (TTP). While the CTD treatment significantly decreased Treg and CD4 cells, it was still not as low or lower than pre-treatment level. All in all, this study’s results suggest a causal link between elevated level

At all stages of MM, from treatment, relapse, remission to refractory, patients will face a high burden of biopsychosocial impacts. MM is characterised by the formation of tumours as a result of the overproduction and accumulation of malignant plasma cells in the bone marrow and other surfaces of bones in various parts of the body (Barber & Mullen, 2017; Dowling, Kelly, & Meenaghan, 2016). Consequently, these tumours causes the inhibition of osteoblasts and elevation of osteoclasts (Silbermann & Roodman, 2013). Thence, it is evident that up to 90% of individuals with MM suffer from hypercalcaemia and increased bone resorption (Silbermann & Roodman).

A 67-year-old male presents to the emergency department with a 2-day history of fever and productive cough. He feels very unwell. The patient is known to have multiple myeloma, a diagnosis established 1 year ago. He was induced with high-dose chemotherapy and maintained on bortezomib. Vital signs: Temperature 38.8ºC (101.8°F), blood pressure 125/88 mmHg, heart rate 98 beats/min, respiratory rate 20 breaths/min. Crepitations are heard in the right middle chest. Chest x-ray shows areas of consolidation in the right middle and lower lobes. They most recent serum protein electrophoresis is seen in the image. The M-spike has increased from 4.5 to 6.3 gm/dL over the past 4 months. The most likely predisposing cause of the patent’s findings is:

On histopathology, desmoplastic Ameloblastoma reveals small areas and thin cords of odontogenic epithelium distributed between dense, fibrous connective tissue.[7] Regions of mature lamellar bone may be seen and invasion may be also be seen.[7 This histological finding indicates the potential for local invasion and also is the reason for the diffuse appearance on radiographs. Desmoplastic Ameloblastoma is so considered more aggressive than other common variants of Ameloblastoma.[7]

Some chemicals like benzene and viruses like T-Lymphotropic virus also contributes to this disease (Vardiman, Thiele et al., 2008).

Bibliographic information: Richard C. Cardoso & Peter J. Gerngross & Theresa M. Hofstede & Donna M. Weber & Mark S. Chambers. Support Care Cancer (2014) 22:259–267 DOI 10.1007/s00520-013-1960-y.