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Multiple Myeloma

Anand Lab Editor

February 7, 2017

Multiple myeloma is a type of blood cancer that affects plasma cells. They account for approximately ten percent of all blood cancers. African-Americans are twice as likely as whites to suffer from this disease. It is rare in Asians.

The plasma cells are normally found in bone marrow. Lymphocytes, which are white blood cells, play an important role in the body defense mechanism against infections. They are divided into T and B cells. The B lymphocytes, in the presence of infections, convert into plasma cells which in turn secrete immunoglobulins or antibodies that help fight the causative organisms. In cancers of plasma cells, there is an overgrowth of these cells which can either form a localized tumor involving one organ called plasmacytoma or involve multiple organs and the bone called Multiple myeloma. There is excessive secretion of abnormal proteins which in turn cause damage to kidneys, recurrent infections, anemia and impaired immune system.

This type of cancer generally occurs in the elderly in mid-sixties. Males are affected slightly more than females. The cause of this condition is clearly identified. The common symptoms include bone pain, weakness, loss of appetite and weight loss.

Of the laboratory investigations, anemia and raised erythrocyte sedimentation rate are common. Some tend to present with kidney disorders. The diagnosis of this condition is usually by a multidisciplinary approach. A detailed clinical examination followed by a spectrum of laboratory and radiological investigations are involved in making the diagnosis.

The laboratory investigations useful in diagnosis include:
• Urine examination for Bence Jone’s proteins
• Complete blood count for anemia
• Erythrocyte sedimentation rate
• Blood urea and serum creatinine to assess the kidney function
• Serum protein electrophoresis and urine electrophoresis to detect elevated abnormal protein called ‘M’ spike.
• Serum protein Immunofixation for characterizing the abnormal protein
• Bone marrow examination
• FISH-gene panel test for diagnosis and prognosis for Myeloma
• CT scan to assess the involvement of bone

The course of the disease and treatment depends on the stage at which the cancer is diagnosed. The mean 5-year survival is around 49.5%. Younger patients are likely to have an increased survival. FISH test for myeloma specific gene panel will help in diagnosis and prognosis (Survival). However, it largely depends on the stage at which the cancer is diagnosed. The treatments include chemotherapy, corticosteroids and stem cell transplantation. Depending on the stage of the disease, one or more treatment options may be used.

Research and laboratory investigations have made great progress in identifying the disease at very early stages. Understanding the symptoms and presentation of the disease and seeking timely medical advice will not only help in early detection but also help the patient and doctor interact better on treatment options and select the best that is available.

Dr. Preethi S Chari,
MD Pathology,
Consultant and Head, Hematology and Immunohematology
Anand Diagnostic Laboratory

Dr. Sundareshan,
PhD Cancer Genetics,
Senior Consultant and Head, Cytogenetics.
Anand Diagnostic Laboratory

Dr. Venkatesh,
MD Biochemistry,
Consultant, Department of Biochemistry.
Anand Diagnostic Laboratory

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