Epidemiology, Staging, and Management of Multiple Myeloma

Abstract

Multiple myeloma (MM) is a plasma cell disorder that is on the rise throughout the world, especially in the US, Australia, and Western Europe. In the US, MM accounts for almost 2% of cancer diagnoses and over 2% of cancer deaths (more than double the global proportion). Incidence has risen by 126% globally and over 40% in the US since 1990, while global mortality has risen by 94% and US mortality has fallen by 18%. The 5 year survival in the US has more than doubled over the past decades with the introduction of new targeted therapies and transplant techniques. Risk factors for MM include age (average age of diagnosis is 69), race (African Americans are over double as likely to be diagnosed), sex (men are at a 1.5× risk), and family history. Diagnosis includes serum or urine electrophoresis and free light-chain assay but requires bone marrow biopsy. It is distinguished from smoldering myeloma and monoclonal gammopathy of undetermined significance by a high (>3 g/dL) level of M-protein (monoclonal light chains) and the presence of CRAB (Hypercalcemia, Renal failure, Anemia, Bone pain) symptoms, which include hypercalcemia, renal failure, anemia, and bone pain, suggesting an end-organ damage. International staging system staging involves beta 2 microglobulin and albumin levels, while the revised system considers prognostic factors such as lactate dehydrogenase levels and chromosomal abnormalities. Front-line management includes induction regimen, maintenance therapy and hematopoietic cell transplantation for eligible patients and bisphosphonates or bone-stimulating agents for the prevention of skeletal events. Treatment for relapsed disease includes newly approved monoclonal antibodies like the CD38-targeting daratumumab, proteasome inhibitors, immunomodulating agents, and investigational therapies such as B cell maturation antigen Chimeric antigen receptor T cells.

Autologous Stem Cell Transplantation in Multiple Myeloma: Where Are We and Where Do We Want to Go?

“…Multiple myeloma (MM), a clonal plasma cells hematologic malignancy, accounts globally for 0.9% of all cancers diagnosed; the incidence increased by 126% from 1990 to 2016, especially in the developed world, e.g., Australia, western Europe, and US, where in 2020 it accounted for 1.8% of all cancers. Median age at diagnosis is 69 years, and about 65% of patients with newly diagnosed MM (NDMM) are between 45 and 74 years old [ 1 ]. MM is characterized by extreme inter-and intra-patient heterogenicities so much that there is the idea that MM should no longer considered a single disease but as different entities that are increasingly shared.…”

High Carbohydrate Diet Is Associated with Severe Clinical Indicators, but Not with Nutrition Knowledge Score in Patients with Multiple Myeloma

“…In 2020, the global age-standardized incidence rates for multiple myeloma (MM) were 2.2/100,000 for males and 1.5/100,000 for females, with an age-standardized mortality rate of 1.1/100,000 [1]. Recognized and relatively constant risk factors are older age, male gender and African ethnicity [2]. Due to new therapies and constant improvements in care, survival has more than doubled over recent decades.…”

Instance Segmentation of Multiple Myeloma Cells Using Deep-Wise Data Augmentation and Mask R-CNN

“…Once B cells respond to infections, they mature and change into plasma cells. In healthy conditions, plasma cells produce antibodies called “immunoglobulin” to fight against infections and diseases [ 2 ]. However, when myeloma cancer occurs, plasma cells in the bone marrow accumulate and crowd out other healthy RBCs and platelets.…”

“…Based on the statistical data of the Global Cancer Observatory (GLOBOCAN), approximately 160,000 global incidences of MM were found in 2018, and it was 0.9% of all cancer diagnoses [ 2 ]. Moreover, there were around 106,000 global mortality cases, approximately 1.1% of all cancer deaths.…”