What is myeloma?

Myeloma is a type of blood cancer that develops from plasma cells. Plasma cells are a type of white blood cell made in the bone marrow. In the UK, around 5,500 people are diagnosed with myeloma each year.

With myeloma the plasma cell makes lots of abnormal (cancerous) plasma cells. We call these myeloma cells. These myeloma cells fill up the bone marrow. This makes it harder for the bone marrow to make enough other normal blood cells. This causes some of the symptoms of myeloma.

Myeloma cells can affect the bone marrow and bones in different parts of the body. This is why it is sometimes called multiple myeloma. It can cause bone pain, bone thinning and sometimes breaks the bones (called fractures).

Myeloma can also affect the kidneys.

Plasma cells make immunoglobulins (antibodies). They help fight viruses or bacteria in the body. But myeloma cells make an abnormal immunoglobulin called a paraprotein which cannot fight infection. You may also make less normal immunoglobulins than usual. This makes it harder for your body to fight infections.

We have more information about immunoglobulins and myeloma.

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Types of myeloma

There are different types of myeloma. They are named after the abnormal immunoglobulin (paraprotein) the myeloma cells make. But they are all usually treated in the same way.

Some people have myeloma that is not causing symptoms. Doctors call this smouldering myeloma.

Certain plasma cell conditions can sometimes develop into myeloma. This includes MGUS (monoclonal gammopathy of unknown significance).

Symptoms of myeloma

There are different symptoms of myeloma. They include:

  • bone pain
  • feeling very tired
  • and getting different infections.

Some people are diagnosed with myeloma after a routine blood test. They may not have noticed any symptoms before this.

We have more information about the symptoms of myeloma.

Causes of myeloma

Doctors do not know what causes myeloma. Different things we call risk factors can increase the chance of developing it. These include being older or having had the condition MGUS first.

Having risk factors does not mean someone will get myeloma.

We have more information about the causes and risk factors of myeloma.

Diagnosis of myeloma

Myeloma can be diagnosed in different ways. Some people see their GP about their symptoms. The GP may do blood tests or arrange x-rays. They refer you to hospital to see a doctor who specialises in blood conditions (haematologist) or a cancer doctor.

Some people are diagnosed after being admitted to hospital with more severe symptoms. These may be caused by complications of myeloma, such as bone problems or kidney problems.

If you don’t have symptoms, you may be referred because of the results of a routine blood test.

At the hospital the specialist doctor will tell you what tests you need. You may also meet a specialist nurse who gives you information and support.

Tests to diagnose myeloma include:

  • Blood tests are used to help diagnose and to monitor myeloma
  • Urine tests to check for Bence Jones protein in your urine
  • X-rays to look at different bones
  • a bone marrow test to look at myeloma cells in the bone marrow (where blood cells are made)
  • tests on the myeloma cells to look for changes in the chromosomes of the cell (called cytogenetic testing). Chromosomes are made up of genes. Genes carry instructions cells need to work properly.
  • different types of scans, such as an MRI, CT scan or PET-CT scan.

Stages of myeloma

The stage shows how quickly or slowly myeloma may develop using the results of blood tests. It also looks at the effects myeloma is having on your body. Myeloma is staged from stage 1 to 3.

We have more information about staging of myeloma.

Treatment for myeloma

There are different treatments for myeloma. A team of specialists meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your doctor and nurse will talk to you about the best treatment for you. They can talk to you about things to think about when making treatment decisions. You may be offered some treatments as part of a clinical trial.

If you have myeloma with no symptoms (smouldering myeloma), you won’t need treatment straight away. But you will have regular check-ups and tests. This is called active monitoring.

If you have myeloma with symptoms (active myeloma) you usually have a combination of different treatments. The aim is to reduce the number of myeloma cells to as few as possible and manage the symptoms.

Some people may have more intensive treatment for myeloma. Your doctor will explain more about this.

Treatment usually includes:

  • Targeted therapies and immunotherapy drugs

    You may have targeted and immunotherapy drugs called thalidomide or bortezomib along with chemotherapy and steroids.

  • Chemotherapy

    Chemotherapy destroys cancer cells. You will usually have 2 or more chemotherapy drugs with other treatments.

  • Steroids

    Steroids are drugs that can be used for different reasons. They help destroy myeloma cells and make the other treatments work better.

  • Stem cell transplants

    Some people have a stem cell transplant. This is an intensive treatment and is not suitable for everyone. Usually an autologous stem cell transplant is used to treat myeloma. Occasionally a donor stem cell transplant is used.

Treatment aims to reduce the number of myeloma cells to as few as possible. This is called remission.

Treating bone problems and other symptoms of myeloma

Myeloma can cause symptoms and complications. Managing these is often an important part of your treatment.

We have more information about:

  • Treatments for myeloma bone problems such as bisphosphonates.
  • Managing other complications such as kidney problems or infections. 

Treating myeloma that comes back

Treatment for myeloma is very effective and many people go into remission. But myeloma usually comes back after a time. This is sometimes called relapsed myeloma. You can usually have further treatment to treat or control myeloma again.

After myeloma treatment

After your treatment has finished, you will have regular check-ups with your cancer doctor or nurse. These can include a physical examination, blood tests, x-rays or scans. We have more information on follow-up care after treatment.

If you have smouldering myeloma you will also have follow‑up checks every few months.

Coping with myeloma after treatment

There are different things you can do after treatment to look after yourself and recover from treatment. We have more information on coping after treatment.

Advanced myeloma

If myeloma is advanced and can no longer be controlled with treatment it can be difficult to cope with. You may feel shocked and find it hard to understand. Or you may have questions about what to expect. Your doctor and specialist nurse are there to help. They can explain how symptoms will be managed and how they can support you. We have more information about coping with advanced cancer that you may find helpful.

Getting support

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan can offer emotional, practical and financial help and support.

The organisations below also offer information and support:

  • ACLT (African Caribbean Leukaemia Trust)
    ACLT offers support for people from ethnic minorities affected by leukaemia and related illnesses.
  • Anthony Nolan
    Anthony Nolan is the UK’s largest stem cell and bone marrow register.
  • Blood Cancer UK
    Blood Cancer UK is a blood cancer research charity that provides information and support on any type of blood cancer.
Reviewed: 31 July 2020
Reviewed: 31/07/2020
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Next review: 31 July 2018
Next review: 31/07/2018