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Multiple myeloma is cancer of the plasma cells in bone marrow.

Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multiple

Plasma cells help the body's immune system fight disease by producing substances called antibodies. In multiple myeloma, plasma cells grow out of control and form tumors in the bone marrow.

The excess growth of plasma cells interferes with the body's ability to make red blood cells, white blood cells, and platelets. This causes anemia, which makes a person more likely to get infections and have abnormal bleeding.

As the cancer cells grow in the bone marrow, they can cause pain and destruction of the bones. If the bones in the spine are affected, it can put pressure on the nerves, resulting in numbness or paralysis.

Multiple myeloma mainly affects older adults. A history of radiation therapy raises your risk for this type of cancer.

• Bleeding problems
• Bone or back pain
• Increased susceptibility to infection
• Symptoms of anemia (such as tiredness, shortness of breath, and fatigue)
• Unexplained fractures

Blood tests can help diagnose this disease. They may include:

• Blood chemistry (CHEM 20) may show increased levels of calcium, total protein, and abnormal kidney function
• Complete blood count (CBC) reveals low numbers of red and white blood cells and platelets
• Serum protein electropheresis (SPEP)
• Urine protein electrophoresis (UPEP) or Bence-Jones protein analysis
• Quantitative immunoglobulins (nephelometry)

Bone x-rays show fractures or hollowed out areas of bone. If your doctor suspects this type of cancer, a bone marrow biopsy will be performed.

The stress of illness may be eased by joining a support group whose members share common experiences and problems. See: Cancer - support group

Survival of people with multiple myeloma depends on the patient's age and the stage of disease. Some cases are very aggressive, while others take years to get worse.

Kidney failure is a frequent complication. Other complications may include:

• Bone fractures
• Increased chances for infection (especially pneumonia)
• Paralysis from tumor or spinal cord compression

Call your health care provider if you experience decreased urine output.

Call your provider if you have multiple myeloma and infection develops, or numbness, loss of movement, or loss of sensation develops.

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Multiple Myeloma. National Comprehensive Cancer Network; 2009. Version 2.2009.

Rajkumar S, Kyle R. Plasma cell disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 198.