EWE 28: Myeloma Definition Causes Treatment Multiple Myeloma

Myeloma Definition Causes Symptoms Treatment Multiple Myeloma: If you have cancer of the bone marrow then here is how to treat multiple myeloma without risk of recurrence. This is because multiple myeloma is a cancer of the bone marrow in which certain white blood cells, the plasma cells, secrete an abnormal amount of immunoglobulin. The disease often affects several bone marrow-rich bones, hence the name “multiple myeloma”. Don't worry, we have a treatment for your case

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Antigens, antibodies, and plasma cells

What are Antigens?

Antigens are on the surface of bacteria, viruses, cancer cells, and other foreign invaders. Antigens stimulate the immune system, especially plasma cells, to produce antibodies that act against an antigen.

What are plasma cells?

A plasma cell is a type of protein made by the immune system to neutralize or destroy an antigen that is a particular foreign substance that has appeared in the body. Plasma cells are seen in the bone marrow, where blood cells are made. A normal bone marrow contains few plasma cells. The bone marrow of a person with multiple myeloma often contains many abnormal plasma cells (myeloma cells).

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What are antibodies?

Antibodies, or immunoglobulins, are special proteins that fight infections and defend the body against pathogens. They circulate in the bloodstream and attach to specific antigens on the surface of bacteria, viruses, or other foreign substances.

The antibodies are specific to a particular antigen. When the immune system identifies a new antigen, a plasma cell makes a new antibody. Once a plasma cell has responded to an antigen, it will make antibodies only for that antigen

Bone and bone marrow

Bones are the structures that make up most of the skeleton. A bone is either hard and dense (compact bone) or organized like a honeycomb (spongy bone). The bone marrow is the soft, spongy substance in the center of bones where blood cells are made. In adults, the bone marrow that makes most of the blood cells (active bone marrow) is in the bones of the pelvis and shoulder, spine (vertebrae), ribs, breastbone, and skull. Plasma cells usually develop in areas where the bone marrow is active.

There are 2 main types of bone cells that work together to disintegrate old or damaged bones and to make new bone tissue.

Osteoblasts form bones.

Osteoclasts disintegrate and reshape bones as they grow or as they are stressed. Osteoclasts also help control blood calcium levels by releasing calcium into the blood as they disintegrate bones

Definition of myeloma:

Myeloma, multiple myeloma, or Kahler disease is a cancer of the bone marrow (the marrow inside the bone, not the spinal cord) that originates in plasma cells. It is recalled that, plasma cells are a type of white blood cell that make antibodies (immunoglobulins) to help fight infections. Thus, multiple myeloma is a blood cancer, or hematological cancer, since it affects blood cells. This bone marrow is contained in some of the bones in our body and makes blood cells.

What are the signs of myeloma?

excessive thirst, need to urinate often, dehydration, kidney problems including kidney failure, constipation, loss of appetite, abdominal pain, weakness, drowsiness, confusion, nausea and vomiting or lethargy caused by a high level of calcium in the blood (hypercalcaemia);

Description of myeloma

Of the ‘mother’ cells in the bone marrow (the ‘stem cells’) that make white blood cells, the ‘plasma cell’ becomes abnormal for unknown reasons. The plasma cell is a cell that normally produces antibodies (or “immunoglobulins”), one of the body’s defense tools against infection. Myeloma cause and symptom

In myeloma, this diseased plasma cell then starts to multiply in an uncontrolled way and all the malignant cells resulting from the proliferation of the diseased plasma cell form a mass of identical cells (“cell clone”), which continue to do what they are programmed to do: make an antibody and, in this case, these plasma cells all produce the same antibody. This “monoclonal” antibody is specific for the plasma cell causing the disease: it is sometimes called “monoclonal protein” or “paraprotein”. Myeloma cause and symptom

What is bone marrow and what is its role in the body?

Bone marrow is found in most of our bones (except the distal bones in adults) and it is in this organ that billions of cells are made every day that will make up the blood cells:

· The red blood cells, or “erythrocytes”, are responsible for transporting oxygen from the lungs to the cells of the whole body and thus allowing them to function, The white blood cells, or “leukocytes”, are of different types (polymorphonuclear leukocytes, lymphocytes, plasma cells, etc.) and are responsible for defending the body against infections,

· Platelets are small structures that are essential for initiating blood clotting in a wound. Myeloma cause and symptom

Causes of Myeloma

The factors that cause myeloma are as yet unknown, apart from high doses of ionizing radiation. As this is a rare disease, the role of environmental factors is difficult to demonstrate.

Indeed, the only known factor today is exposure to ionizing radiation. This is the case among radiologists who previously lacked adequate protection, or among survivors of a nuclear explosion. But radiation therapy for cancer, breast cancer or any other type of cancer, does not predispose people to a disease such as myeloma. Myeloma cause and symptom

There is no reliable way to link the development of myeloma to another environmental cause. Pesticides, hair dyes, and other occupational toxins have been implicated in the past, but nothing has been shown. As regards pesticides, it is known that they may indeed be involved in a number of blood diseases, such as lymphomas, but there is no evidence for myeloma. Benzene-associated myeloma is recognized as an occupational disease "in Table 4", but it is also recognized as an occupational disease in the same way as other blood cancers such as acute leukemias and lymphomas. In addition, there are as many people affected by myeloma in cities as in the countryside.

Thus, the cause of myeloma is likely to be multifactorial, involving various environmental, chemical, or infectious (virus) phenomena.

The search for familial genetic factors that contribute to myeloma is ongoing. But, while uncommon familial forms of myeloma may be the result of a genetic predisposition, with gene vulnerability passed from parent to child, they can also be the result of shared exposure to unknown agents. Myeloma does not spread to its offspring and does not contract through contagion. Myeloma cause and symptom

What are the risk factors for myeloma?

It is not yet clear what causes a healthy plasma cell to malfunction. However, some risk factors have been identified by medical research:

Myeloma is a bit more male
What are myeloma symptoms?

In about 20% of cases, the myeloma is asymptomatic and is only discovered when a blood test reveals the presence of an excess of antibodies - this is called "asymptomatic multiple myeloma". However, some symptoms are characteristic of advanced disease:

Bone pain, especially in the vertebrae,
Frequent (micro-) fractures, especially of long bones (femurs, humerus), ribs, or vertebrae (vertebral collapse). These bone lesions, which affect 80% of patients, are also called “lytic lesions” or “osteolytic lesions”,
Hypercalcaemia, which is an abnormally high amount of calcium circulating in the blood,
Renal failure,
Anemia (a decrease in the number of red blood cells),
Repeated infections (pulmonary, ENT...)