Multiple Myeloma: An Update

Abstract

Multiple myeloma is a rare, largely incurable malignant disease of plasma cells. Patients usually present with hypercalcemia, renal insufficiency, anemia and/or lytic bony lesions along with a monoclonal protein in the serum and/or urine in addition to an increase in the number of clonal plasma cells in the bone marrow. Patients with myeloma live on an average for five to seven years, with their survival dependent on the presence or absence of different prognostic markers. Treatment of younger fit patients is with induction therapy consisting of steroids with one or more novel anti-myeloma agents followed by high dose melphalan and autologous stem cell transplantation, while older and less fit patients are treated with melphalan-based combination chemotherapy. Supportive care is of paramount importance and includes the use of bisphosphonates, prophylactic antibiotics, thrombosis prophylaxis and the use of hematopoietic growth factors along with the treatment of complications of disease and its therapy. As more progress is being made and deeper responses are being attained, the disease might turn into a potentially curable one in the near future.

Relapse of Multiple Myeloma Presenting as Lower Lip Numbness

“…plasmacytoma), the presence of a monoclonal protein or light chain and end-organ damage, indicated by hypercalcaemia, renal insufficiency, anaemia and bony lesions. 2,10 The incidence of MM occurring in the maxillofacial region as either a primary manifestation or relapse is low, with few reported cases. 4,[11][12][13] Usually, MM appears via imaging as radiolucency in the jaw and the patient may also complain of pain, swelling and mobile teeth.…”

Multiple Myeloma: New Perspectives

“…The most common presenting symptoms are fatigue and bone pain. Osteolytic bone lesions and compression fractures are the hallmark of the disease [1]. Anemia occurs in 70% of patients at diagnosis and is the primary cause of fatigue.…”

“…When chromosomes and genes are damaged, this control is lost. Often, a promoter gene moves to a certain chromosome where it stimulates an antibody gene to overproduction [1].…”

“…The specific immunoglobulin produced by the malignant cells is the M-protein which is abundant in serum and/or urine of patients affected with MM [1]. The usual clinical presentation of MM includes bone destruction, hypercalcemia, renal damage, anemia and increased susceptibility to opportunistic infections.…”

“…Diagnosis of MM usually depends on detection of abnormal antibodies in blood or urine tests, the presence of malignant plasma cells on bone marrow biopsy and medical imaging finding bone lesions. Also, cases of MM may have a common finding of high blood calcium levels [1]. MM is considered treatable but generally incurable disease.…”