How Aggressive Is Multiple Myeloma & How Is It Treated?

Myeloma refers to the cells’ blood cancer found mainly in the patient’s bone marrow, especially the plasma cells. Bone marrow implies a spongy tissue present in the bones of humans, which usually create various blood components. Plasma cells are the essential parts of one’s immune system and they produce antibodies to fight with various infections. Myeloma starts whenever there are changes in healthy plasma cells and they grow out of their control. Because of this, you experience multiple bone lesions, which further increase your risks related to fracture. Abnormal plasma cells may crowd out or suppress other cells’ growth in the person’s bone marrow to produce platelets, white blood cells and red blood cells. Even multiple myeloma reduces the ability to create regular plasma cells, which further results in low immunity.

How Aggressive Is Multiple Myeloma?

Symptoms related to multiple myeloma become aggressive in its third stage. However, specific health conditions depend solely on the analysis done according to different systems. (1)

Durie-Salmon System

Durie-Salmon System is the traditional system to determine the stage of myeloma. The system is responsible to find out the size of one’s tumor or extent of the multiple myeloma disease. According to this-

3rd Stage/Aggressive Stage

Most of the cancer cells remain present in the patients’ body during their third stage and the characteristics include-

  • Anemia problem with less than 8.5 gram/dL of hemoglobin
  • Hypercalcemia
  • Advanced level of bone damage i.e. about three or more than three bone lesions
  • M Protein is present in high level in both urine and blood (3)

International Staging System

International Staging System determines a few important factors influencing the survival of multiple myeloma patients. Moreover, the system determines three different stages of the disease in accordance with the serum albumin measurement and serum beta-2 M levels. Accordingly, any patient in his/her stage 3 has beta-2 M higher than 5.5 mg/L.

Detailed Analysis On Treatment And Outcome Of Aggressive Multiple Myeloma

Treatment Procedures

Medical researchers have conducted analysis of eight different patients suffering from stage III i.e. aggressive form of multiple myeloma. Doctors treat them with high dosage of chemotherapy and total body irradiation in combination with auto-grafting with the help of blood stem cells. To perform the auto-grafting procedure, doctors have collected cells from leukapheresis done during the hematologic recovery combined with aplasia of bone marrow with cytotoxic drug in its induced form. (2)

Outcomes At A Glance

  • Seven patients remained alive for about 9 months to 17 months after their treatment procedures.
  • One patient died on 40th day due to cerebral bleeding.
  • All other living patients succeeded to obtain massive reduction of about 90 percent in their tumor masses.
  • In two cases, CR i.e. complete remission persists during the follow-up phase of 15 months and 16 months.
  • A patient in the apparent RD and apparent CR has relapsed 12 months and 9months respectively after the treatment procedure.

Autologous blood obtained from stem cells in the hematopoietic form induced many sustained and successful engraftment in each of the living patients. Even though the mentioned results are of preliminary ones, they indicate that TBI and HDC in combination with auto-graft via blood stem cells posses both theoretical and practical interest over autologous and allogenic bone marrow transplant. Hence, these treatment options are recommendable among patients dealing with multiple myeloma.

Conclusion

To conclude, we should say that multiple myeloma becomes aggressive when it reaches to Stage III; however, its extent is controllable with the combination of aforementioned treatment options. These include high dosage of chemotherapy, total body irradiation and auto graft.

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/2562921
  2. https://www.ncbi.nlm.nih.gov/pubmed/2562921
  3. https://www.ncbi.nlm.nih.gov/books/NBK534764/

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