Multiple myeloma is a certain form of cancer of the plasma cell, which is part of the immune system. It initiates in the bone marrow, where the blood cells are produced.The immune system is made of variety of cells that fight infections and keep the body healthy.
What takes place in bone marrow that is healthy?
The bone marrow is located in the soft, spongy middle of some particular bones. Any bones that have active marrow can be affected by myeloma. The marrow in adults is normally active only in the spine, hips, ribs, pelvis and shoulders.
The three major kinds of blood cells that are crucial to the human body are generated by healthy bone marrow. They are:
- The red blood cells that transport oxygen
- The platelets that are responsible for clotting and stopping bleeding
- The white blood cells that battle infections
The white blood cells (known as B cells or B lymphocytes) change into plasma cells when viruses or bacteria invade your body. Antibodies are then generated by these plasma cells to kill the bacteria or virus that has entered your body. Antibodies are complex proteins.
What takes place in myeloma?
The plasma cells in a myeloma patient do not reproduce normally, but instead, they develop into cancerous cells, where they split and grow uncontrollably. Also known as myeloma cells, these cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. This may lead to an infection,low blood counts or anemia and problems with blood clotting.Multiple myeloma mostly affects active bone marrow like the marrow in the spine, ribs, shoulders, pelvic bones and the hips.
Myeloma patients have an immune system that is weaker than normal since the myeloma cells do not produce antibodies effectively.
Myeloma cells generate and discharge abnormal proteins (M proteins) and other chemicals instead of generating effective antibodies. The surrounding area can be damaged by these substances, and they can also go through the bloodstream and cause harm to other body parts.
For example, the hard, structural parts of bones can dissolve when some of the chemicals interact with the bone cells. The damaged parts are known as osteolytic lesions. They make the bone weak and may cause fractures. One of the main effects of myeloma is bone damage. These lesions or bone damage are common symptoms but they do not occur in all persons diagnosed with myeloma. Calcium is let free in the bloodstream when the bone dissolves. Health complications like dehydration and confusion are results of high calcium levels in the blood, also known as hypercalcemia, and can also cause harm to the kidneys.
Kidney damage can also be caused by a lot of protein, like damage to the tiny tubes contained in these organs, and result to circulation complications since these proteins have a habit of sticking to one another and to other tissue, which leads to blood thickening.
Why the name "multiple myeloma"?
The majority of myeloma patients have myeloma tumors in a number of parts in their body, hence the name multiple myeloma.
Other myeloma patients may have only one tumor. Plasmacytoma is the name given to a single tumor. "Plasma" means the affected cell, "cyte" is for cell, and "oma" refers to a tumor. Patients with a single tumor usually develop multiple myeloma later in their lives.
Myeloma is not a type of bone cancer, although it mainly affects the bones. It starts in cells in the bone marrow; hence it is a hematologic distortion.
Risk factors for multiple myeloma
What exactly causes multiple myeloma is unclear, so there have been no risk factors that have been identified.Scientists, through research, have only been able to find out how the disease develops. Certain things, however, can make you susceptible to multiple myeloma.These factors lead to a decline in the immune system of a person and hence are viewed as potential risk factors.
- Exposure to radiation- Some people are exposed to radiation and chemicals due to their jobs which make them vulnerable.
- Family history- If a parent or sibling has this disease you are much more vulnerable but such cases have been found to be rare.
- Age (65 and above)– More than half (about 60%) the diagnosed cases are in people above 65 years of age. About thirty percent are seen in people above 45 years of age. With age, people become more vulnerable to this disease. Thus age is the most important risk factor.
- Gender- Men are more likely to develop myeloma.
- Race-Myeloma is found more in African-American people than Americans.
- Infections of other plasma cellssuch as MGUS and Solitary Plasmacytoma.
- Working in an oil-related industryas per studies but not proved.
People working in agriculture sector, workers in leather industries and cosmetologists are at higher risk than others. Those who are exposed to insecticides, petroleum products, heavy metals, plastics and asbestos dust are also more vulnerable as these can impair the immune system.
- Solitary Plasmacytoma – People having a single tumor of plasma cells are more likely to develop multiple myeloma.
- MGUS (monoclonal gammopathy of undetermined significance)
A blood test will reveal whether the person has MGUS. Those diagnosed with multiple myeloma have MGUS but not everyone with MGUS have multiple myeloma.Some persons with MGUS may later on develop this condition.
The above factors can pose a risk for developing myeloma but the connection has not been proven. Sometimes individuals who are not exposed to these factors also have developed myeloma. Multiple myeloma can occur due to more than one factor acting in unison. Myeloma is not considered to be a hereditary disease but according to research some genetic factors are responsible for its development. Due to the advances in technology, ‘mapping the genome’ is now possible. Scientists are now able to find out where the abnormalities lie and identify those genes that make the person at risk of contracting multiple myeloma. This helps the doctor to know how effective a particular treatment will be.
Genetic counseling is recommended since multiple myeloma can be passed down from one generation to another. Hence, it is imperative for a person to seek medical advice in order to curb the situation at hand.