blood disorders
Multiple Myeloma
Introduction
Multiple myeloma is a cancer of plasma cells in which abnormal plasma cells multiply uncontrollably in the bone marrow and occasionally in other parts of the body. People often have bone pain and fractures, and they may also have kidney problems, a weakened immune system (immunocompromise), weakness, and confusion. Diagnosis is made by measuring the amounts of different types of antibodies in blood and urine and confirmed by a bone marrow biopsy. Treatment often includes some combination of conventional chemotherapy drugs, corticosteroids, and one or more of the following: proteasome inhibitors (such asbortezomib,carfilzomib, orixazomib), immunomodulatory drugs (such aslenalidomide,thalidomide,pomalidomide, orvenetoclax), a nuclear export inhibitorselinexor, or monoclonal antibodies (includingdaratumumab,isatuximab, orelotuzumab). Plasma cells develop from B cells ( B cells ), a type of white blood cell that normally produces The average age of people with multiple myeloma is about 70 years. Although its cause is not certain, the increased occurrence of multiple myeloma among close relatives indicates that heredity plays a role. Exposure to radiation is thought to be a possible cause, as is exposure to benzene and other solvents. Normally, B cells make up less than 1% of the cells in the bone marrow. In multiple myeloma, typically the majority of bone marrow elements are cancerous plasma cells. The overabundance of these cancerous plasma cells in the bone marrow leads to the increased production of proteins that suppress the development of other normal bone marrow elements, including Often, collections of cancerous plasma cells develop into tumors within bones. The cancerous cells also secrete substances that cause loss of bone, most commonly in the pelvic bones, spine, ribs, and skull. Infrequently, these tumors develop in areas other than bone, particularly in the lungs, liver, and kidneys. 