Multiple myeloma is a malignant tumour that occurs as a result of differentiated B-cells (plasma cells). The disease is found in 2-3 cases per 100,000 of population per year.
Men suffer one and a half times more often than women. Negroid race representatives are under higher risks while multiple myeloma is not as common among the Japanese and Chinese.
Etiology of the disease is not yet established. Only few risk factors of the development of the disease are known:
The disease occurs immediately. The first symptom can be:
45% of the patients who were just diagnosed with the multiple myeloma have renal dysfunction. For 15% of patients, renal dysfunction manifests itself in oliguria (reduced urine excretion) and requires dialysis.
80% of patients with stages 2 and 3 of multiple myeloma are observed with having radiographic signs of bone disease. 50% of patients have osteolysis (detriment of the bone tissues).
Calcium level is increased in the blood, which can be proved by the following symptoms:
All the organs are involved in the pathological process one way or another. The symptoms are connected and often experience overall damage such as:
Hence multiple myeloma significantly lowers the immune system. The cause of death for most patients are infections or kidney failure.
Main methods of multiple myeloma diagnostics are:
The first two criteria are main ones. They make an accurate diagnosis possible, however some of the X-ray symptoms may not be seen among certain patients. Also, this symptom is not pathognomonic. Not every case of general osteoporosis shows evidence of multiple myeloma.
The stage of the disease is verified the following way:
Stage 1. Hemoglobin level is less than 100 g / l, the low degree of generating monoclonal protein (IgG is less than 50 g / l G-myeloma IgA is less than 30 g / l for an A-myeloma), calcium level in the blood is normal, light chains of immunoglobulins excretion with urine is less than 4 g per day, X-ray shows the normal rate or not exceeding 1 case of solitary degradation.
Stage 2. Hemoglobin level is 85-100 g / l, the average degree of monoclonal protein production (IgG is 70-50 g / l for G-myeloma, IgA is 30-50 g / l for an A-myeloma), and urinary excretion of immunoglobulin light chains is between 4-12 g per day.
Stage 3. Hemoglobin level is less than 85 g / L, a high degree of generation of monoclonal protein (IgG is more than 70 g / l for a G-myeloma, IgA is more than 50 g / l for an A-myeloma), elevated blood calcium level, urinary excretion of the light chains of immunoglobulins is more than 12 g day, X-ray shows signs of multiple foci of destruction.
Each stage can have a substage A or B, depending on the renal function. If the serum creatinine is normal then multiple myeloma A is diagnosed, if it is elevated, than substage B is verified.
Chemotherapy is the main treatment method used to treat the majority of patients who have multiple myeloma. During the therapy medications that block the malignant cells growth are administered. Chemotherapy cannot treat the disease, but the stable remission period can be reached and the patient’s life span can be prolonged for several years.
Stem cells transplantation is an expensive form of surgery therefore it is rarely used, but it offers great results even if the prognosis of the chemotherapy is negative. Autologous transplantation (own stem cells) or allotransplantation (a donor’s stem cells) are used. Stem cells are taken from the bone marrow or from the periphery blood. Before the cells are to be transplanted, the patient’s own bone marrow is destroyed with the help of high doses of the chemotherapy and radiation therapy.
Auto- and allotransplantation have their advantages and disadvantages.
Supportive therapy. The patients are prescribed the pathogenic treatment aimed at the support of the disrupted organism functions and improving the patient’s quality of life. The struggle with the kidney failure, bone demineralization, anaemia and other conditions that accompany multiple myeloma is treated.
The average life span of patients after diagnosis, depends on the stage of the disease:
In recent years there has been a trend towards an increase in life expectancy of patients with multiple myeloma, which is due to the constant improvement of methods of treatment. There are new drugs and regimens that can ensure a stable remission.
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