Is Multiple Myeloma Always Fatal?

Reviewed on 6/4/2021

Multiple myeloma is a type of blood cancer that is somewhat rare and typically has a poor prognosis. Several factors play an important part in a person's survival rate, including age, health condition, and whether it involves a single tumor.
Multiple myeloma is a type of blood cancer that is somewhat rare and typically has a poor prognosis. Several factors play an important part in a person's survival rate, including age, health condition, and whether it involves a single tumor.

Multiple myeloma is a relatively rare cancer that occurs when plasma cells in the blood grow abnormally and out of control. 

Multiple myeloma had a very poor prognosis in the past, however, the outlook and survival rates for the disease are improving due to newer treatments. While there is no cure, a number of factors affect a person’s chances of survival after diagnosis:

  • Age: survival rates are higher in younger people 
  • Overall health
  • Whether a single plasmacytoma (single tumor) is found or if multiple myeloma is diagnosed
  • The tumor’s chromosome changes (cytogenetics)
  • The levels of certain proteins and other substances in the blood
  • Kidney function 

Life expectancy for multiple myeloma is often expressed in five-year survival rates, that is, how many people will be alive five years after diagnosis. 

  • Multiple myeloma five-year survival rates:
  • Localized (solitary plasmacytoma): 75%
    • About 95% of cases are diagnosed at this stage
  • Regional: Not applicable 
  • Distant (multiple myeloma): 53%

What Are Multiple Myeloma Symptoms?

It is possible to have multiple myeloma and not notice any symptoms. Symptoms of multiple myeloma occur can include:

  • Bone problems: pain, weakness, fractures
  • Low blood counts of red blood cells (anemia), white blood cells (leukopenia), or plasma cells (thrombocytopenia)
  • High blood levels of calcium (hypercalcemia)
  • Infections, including pneumonia
  • Nervous system symptoms if the bones in the spine weaken and cause spinal cord compression, a medical emergency. See a doctor right away if you have: 
    • Sudden severe back pain
    • Numbness, usually in the legs
    • Muscle weakness, usually in the legs
  • Nerve damage 
    • Weakness and numbness 
    • “Pins and needles” 
  • Kidney problems
    • Shortness of breath
    • Itching
    • Leg swelling
    • Weakness
  • Thickened blood (hyperviscosity) that slows blood flow to the brain
    • Dizziness
    • Confusion
    • Stroke symptoms, such as slurred speech and weakness on one side of the body

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What Are the Causes and Risk Factors of Multiple Myeloma?

The cause of multiple myeloma is not known, but a possible cause may be due to genetic changes (mutations). 

Risk factors that may increase the chance of developing multiple myeloma include:

  • Age: over 65 years old
  • Gender: men are slightly more likely to develop multiple myeloma 
  • Family history
  • Obesity
  • Race: more than twice as common in African Americans than in white Americans
  • Having other plasma cell diseases

How Do You Get a Multiple Myeloma Diagnosis?

Your doctor will review your patient history, and you will also submit to a physical examination, as well as blood, urine, and imaging tests in order to be diagnosed with multiple myeloma. 

Lab tests used to diagnose multiple myeloma include: 

  • Blood tests
    • Complete blood count (CBC
    • Blood chemistry 
    • Levels of creatinine, albumin, calcium, and other electrolytes
    • Quantitative immunoglobulins
    • Lactic dehydrogenase (LDH) levels 
    • Electrophoresis
    • Beta-2 microglobulin
    • Serum free light chains
  • Urine tests 
  • Biopsies
  • Imaging tests
    • Bone X-rays
    • Computed tomography (CT) scan
    • Magnetic resonance imaging (MRI) scan
    • Positron emission tomography (PET) scan
    • Echocardiogram (“echo”) of the heart

A diagnosis of multiple myeloma requires:

  1. A plasma cell tumor (proven by biopsy) OR at least 10% plasma cells in the bone marrow, AND
  2. At least one of the following:
  • Low red blood cell counts (anemia)
  • High blood calcium level
  • Poor kidney function
  • Increase in one type of light chain in the blood so that one type is 100 times more common than the other
  • Holes in the bones from tumor found on imaging studies 
  • 60% or more plasma cells in the bone marrow

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Reviewed on 6/4/2021
References
https://www.cancer.org/cancer/multiple-myeloma.html

https://www.cancer.net/cancer-types/multiple-myeloma/statistics