Multiple myeloma is a blood cancer that starts in plasma cells—a type of white blood cell that normally helps you fight infections by making antibodies. In myeloma, those plasma cells become abnormal, multiply, and build up in the bone marrow (the “factory” inside bones that makes blood cells).
What happens in the body
When myeloma cells take over space in the bone marrow, they can:
- Crowd out healthy blood-making cells, which can lead to anemia (low red blood cells) and higher infection risk.
- Produce abnormal proteins (often called M protein or monoclonal protein) that don’t help fight infection and can contribute to complications, including kidney problems.
- Damage bones, sometimes causing bone pain, weak bones, or fractures.
Common signs and symptoms
Some people have no symptoms at first. When symptoms do show up, they often relate to how myeloma affects blood counts, bones, and organs. Common symptoms include:
- Bone pain (often back, hips, ribs) or fractures
- Fatigue/weakness (often from anemia)
- Frequent infections
- Kidney problems
- High calcium levels (which can cause thirst, constipation, confusion)
How multiple myeloma is diagnosed
Doctors usually use a mix of:
- Blood tests (to check blood counts, kidney function, calcium, and abnormal proteins)
- Urine tests (to detect abnormal proteins)
- Bone marrow biopsy (to measure myeloma cells in the marrow)
- Imaging such as X-ray, CT, MRI, or PET scans (to look for bone damage)
“Pre-myeloma” and earlier stages
Myeloma often develops over time. Some people are diagnosed with:
- MGUS (monoclonal gammopathy of undetermined significance): abnormal protein is present, but there’s no organ damage.
- Smoldering multiple myeloma: more abnormal cells/protein than MGUS, but still no symptoms or organ damage. Some people can stay in this stage for months or years and may not need treatment right away.
Treatment options (what doctors commonly use)
Treatment depends on factors like symptoms, risk level, overall health, kidney function, and whether a stem cell (bone marrow) transplant is an option.
Common approaches include:
- Combination drug therapy (often mixing targeted therapy, immunotherapy, steroids, and sometimes chemo)
- Stem cell transplant (for eligible patients, often after initial treatment)
- CAR T-cell therapy and other advanced immunotherapies (often used in certain situations, such as relapse)
- Supportive care (bone-strengthening meds, pain control, infection prevention, treating anemia, kidney protection)
Living with myeloma: what matters day-to-day
Because myeloma affects bones, blood counts, and immunity, many care plans emphasize:
- Preventing infections (vaccines when appropriate, reporting fevers quickly)
- Protecting bones (fall prevention, bone meds, safe movement/exercise guidance)
- Monitoring kidneys (hydration guidance and medication review)
- Managing fatigue and nutrition (small wins, consistent routines)