Blood cells in our body are produced from hematopoietic stem cells in the bone marrow. Stem cells are multipotent cells that can transform into different cells when affected by certain hormones and growth factors. Abnormal proliferation of any of these cell lines causes blood cancers. Multiple Myeloma can also be defined as plasma cell cancer.
What is Multiple Myeloma?
Plasma cells develop from B-lymphocytes, a white blood cell that is produced in the bone marrow. When a bacteria or virus enters the body, the immune system activates many cell types and immune pathways to fight these agents. Plasma cells also play an important role in the fight against these antigens by producing specialized antibodies against these antigens in the structure of immunoglobulin. In multiple myeloma, with the abnormal increase in plasma cells, appropriate antibodies cannot be produced. These abnormal proteins are called paraproteins or Protein M. These proteins have no use for any function in the body. On the contrary, by thickening the blood and slowing down the blood flow, they cause many symptoms and deterioration in kidney function. The question of whether every plasma cell increase is cancer is also an important issue that needs to be answered. In the disease called MGUS (monoclonal gammopathy of unknown cause), there is an increased formation of paraprotein in the plasma cells, but this disease is not a type of cancer. It usually occurs in patients over 65 years of age, it is rare under 35 years of age. Multiple Myeloma is more common in African-American individuals and less common in Asian-Americans.
What are the Symptoms of Multiple Myeloma?
Symptoms of Multiple Myeloma develop due to the effects of myeloma cells. Abnormal, rapidly proliferating plasma cells are called myeloma cells. Anemia due to suppression of erythrocytes, ie red blood cells, in the bone marrow, thrombocytopenia and a decrease in the production of other white blood cells develop due to the decrease in the production of blood platelets. Symptoms related to these:
- Chronic weakness and fatigue
- Pale skin
- Fatigue, shortness of breath while walking and exercising It should be kept in mind that it is one of the common symptoms of blood cancers and not specific to Multiple Myeloma. In addition, increased immunoglobulins accumulate in the bone structure and form lytic bone lesions (radiologically eaten bone appearance);
- Bone fractures (especially in the spine bones)
- Bone pains (especially in the back and rib bones)
- Renal dysfunction is observed.
What are the Causes of Multiple Myeloma?
It is not known medically why Multiple Myeloma develops and why it is seen in one patient but not in another. However, studies have identified some risk factors for multiple myeloma.
- Advanced age,
- Male gender,
- Black race,
- Multiple Myeloma in one of the siblings,
- Radiation It has been determined that the probability of developing Multiple Myeloma is higher in individuals who have been exposed to it.
How is Multiple Myeloma Diagnosed?
This disease usually occurs when a physician is consulted for other reasons and when the physician suspects it during examinations. In some patients, the diagnosis is made by the symptoms that appear when the disease progresses. Disease history and physical examination may reveal signs of the disease. In the complete blood count examination performed on the patients, low levels of leukocytes, erythrocytes and platelets may be detected. Detection of abnormal M protein in blood in biochemical studies is very important for both diagnosis and follow-up of the disease. To find out if the disease is damaging the kidneys The creatinine value and the blood calcium level, which can reach very high values in this disease, are definitely checked. Protein electrophoresis is applied to detect abnormal proteins in the blood. Electrophoresis gives information about the stage of the disease by showing beta-2 microglobulin and albumin levels.
What are Multiple Myeloma Treatment Methods?
Major developments in the treatment of Multiple Myeloma in recent years have positively affected and increased the life process in this disease. Ongoing research on this disease is a source of hope by producing new treatment methods and protocols every day. Currently, the standard treatment method in patients under 65 years of age and in patients over 65 years of age in good general condition is autologous stem cell-assisted chemotherapy. Various chemotherapy drugs can be used alone or in combination. In targeted therapy, proteasome inhibitors that recognize normal cells and kill only cancer cells, or monoclonal antibody therapy developed against cells carrying CD20 are another option. . In these patients, cortisone therapy can also be used in addition to other treatments in order to destroy the tumor tissue. Patients with chronic disease whose signs and symptoms are not very clear can be followed closely without any treatment with the wait-and-see method. If the proteins released by cancer cells increased to a level that would disrupt the fluidity of the blood and cause symptoms, it was essential to clear these proteins from the blood. r.
For this purpose, plasmapheresis is applied with a device that filters the abnormal proteins in the plasma and returns them back to the blood. Apart from these, one of the most important pillars of treatment is supportive treatments. Since the blood calcium level will often increase in these patients, treatments aimed at lowering it, erythrocyte suspensions in erythrocyte deficiencies and thrombocyte suspensions in thrombocyte deficiencies should be applied, and patients with impaired renal function should be on dialysis. When side effects occur due to drugs, symptomatic treatments should be applied, and patients should be kept away from crowded environments and mass transit vehicles during periods when the white blood cell count decreases and the immune system is suppressed. In the treatment of the disease, in addition to all these drugs, good and healthy nutrition and regular exercise are also important.
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