Complications of Multiple Myeloma

Overview

Multiple myeloma is a type of blood cancer that occurs when plasma cells, which are a type of white blood cell, grow out of control in the bone marrow. The abnormal plasma can crowd out healthy blood cells in the bone marrow and form tumors in bones and soft tissues.

Multiple myeloma can cause a variety of complications that can impact a person's health. Here are some common complications of multiple myeloma and ways to prevent or treat them:

Bone disease: Multiple myeloma can lead to bone disease because the cancer can cause overactivation of cells that break down bone tissue. This can result in bone pain, easy fracturing, spinal cord compression, and high levels of calcium in the blood (hypercalcemia). To treat bone pain, opioid medications are typically used to provide relief. Additionally, biphosphates can be given to improve bone health by inhibiting the activity of the cells that break down bone tissue. Individuals with spinal cord compression may need radiation therapy or surgery.
Low blood counts: In multiple myeloma, cancerous cells in the bone marrow crowd out healthy blood cells, leading to low blood counts. This can result in:
- Anemia: Low red blood cell counts may cause fatigue and shortness of breath. Anemia can be treated using medications called erythropoiesis-stimulating agents, which stimulate the growth of red blood cells. Blood transfusions may also be used to address low red blood cell counts.
- Neutropenia: Low healthy white blood cell counts reduce the body’s ability to fight infection. To reduce the risk of infection, prophylactic antibiotics or antivirals may be prescribed, and receiving influenza and pneumococcal vaccines is important.
- Thrombocytopenia: Low platelet counts may lead to easy bruising or bleeding. Infusions of platelets may be used to treat low platelet counts in people who are bleeding.
Hyperviscosity: Hyperviscosity occurs when abnormal proteins produced by plasma cells in multiple myeloma build up in the blood, making it thicker and affecting circulation. Plasmapheresis is a treatment option for hyperviscosity. It involves removing some of the thickened plasma from the blood and replacing it with healthy donor plasma.
Kidney disease: Kidney disease can occur in people with multiple myeloma due to various factors such as the build-up of abnormal proteins in the blood, infections, medication side effects, dehydration, or preexisting health conditions like diabetes. Staying hydrated during treatment is important for kidney health. The exact treatment for kidney disease during multiple myeloma depends on the cause.
Neuropathy: Some individuals with multiple myeloma may develop neuropathy, which can be caused by disease activity or side effects of treatments. Symptoms may include tingling and weakness. Prescription medications like with certain antiseizure medications or tricyclic antidepressants may help manage neuropathy symptoms.
Hypercalcemia: High levels of calcium in the blood may lead to symptoms such as nausea and vomiting, increased thirst and urination, brain fog or confusion, and kidney problems. Treatment may include intravenous hydration, antiresorptive medications to prevent release of calcium from bone, diuretics to increase elimination of calcium through urine, or hemodialysis.

It's important to note that while these are common complications associated with multiple myeloma, each person's experience may vary. It's always best to consult with a healthcare professional who can provide personalized advice and guidance based on an individual's specific situation.