The plasma cells are among the less common types of white blood cell in the bone marrow. They produce antibodies that help to destroy bacteria, viruses and other infectious agents and foreign cells. They also produce antibodies in response to vaccination or immunization. Normally, plasma cells make up only a small percentage of the cells in the marrow, but in multiple myeloma one plasma cell undergoes a malignant, or life-threatening, change and begins to multiply excessively. This has three serious effects. First, it disrupts the production of red blood cells, platelets and granulocytes (a type of white blood cell) in the marrow, which leads to anemia thrombocytopenia and a reduction of granulocytes in the blood. Second, the excess plasma cells cause destruction of bone. Third, the remaining normal plasma cells produce fewer antibodies and this reduces resistance to infection.

What are the symptoms?

Usually the first symptoms of myeloma are the symptoms associated with anemia. Increased susceptibility to infection may also appear early. The most characteristic symptom of the disease is pain in your bones, particularly in the vertebrae, or backbones.

What are the risks?

Myeloma is a rare disease, occurring in less than 4 of every 100,000 people in the United States. Myeloma affects mainly people over 50 and it is somewhat more common in men than it is in women.

Myeloma cannot be cured, but if you have the disease, treatment can give you several years of fairly normal life. Recurrent infection is a common problem with this disease, and it can be quite serious. There is a risk of chronic kidney failure and bleeding is another common problem.

What should be done?

If you are over 50 and you have developed bone pain, especially in your back, you should see a physician. If you have multiple myeloma, laboratory analysis of blood and urine samples and X-rays of the skeleton will usually detect it.

What is the treatment?

In the early stages of multiple myeloma, if there are no complications, the usual treatment that is currently used is an anticancer drug. The amount of the medication that is given must be carefully controlled, because too much of the drug can damage too many of the other cells in the bone marrow, and too little of it will not be able to halt the progress of the disease. Blood samples are taken during treatment to find an effective, safe dosage. Often steroids are also prescribed.

This treatment controls the disease in many but not all cases. Because your resistance to infection remains low during this treatment, antibiotics may be prescribed if you have any symptoms of an infection. Troublesome bone pain can usually be relieved by radiation therapy. If you respond to treatment at first, and then have a relapse, your physician may try different drugs.

If the disease is not in an advanced stage when it is diagnosed, and if you respond well to treatment, you will probably survive for about two years.

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