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Multiple myeloma also known as myeloma or Kahler's disease. Multiple myeloma is a cancer of the plasma cells in bone marrow. Plasma cells are the cells responsible for forming antibodies against bacteria and foreign proteins. Plasma cells then divide and form abnormal proteins, which results in damage to the bone, the bone marrow, and/or other organs of the body. Multiple myeloma is characterized by excessive numbers of abnormal plasma cells in the bone marrow and overproduction of intact monoclonal immunoglobulin or Bence-Jones protein. Hypercalcemia, anemia, renal damage, augmented susceptibility to bacterial infection, and harmful production of normal immunoglobulin are common clinical manifestations of multiple myeloma. It is often also characterized by diffuse osteoporosis, usually in the pelvis, spine, ribs, and skull. Multiple myeloma can cause a wide variety of problems. Multiple myeloma affects the kidneys in several ways. The most common mechanisms of renal injury are direct tubular injury, amyloidosis, or involvement by plasmacytoma. Spinal cord compression is one of the most severe adverse effects of myeloma. Patients with myeloma commonly develop hypercalcemia. The mechanisms involve bony involvement and, possibly, humoral mechanisms. The cause of multiple myeloma is currently unknown. This disease is uncommon in young adults and becomes ever more common with advancing age. Only about 2% of cases in the UK occur in people under the age of 40 years. It is slightly more common in men than in women. It can often run in families. Multiple myeloma is also more common in blacks than in whites. The workers in agriculture or petroleum-based industries may be at greater risk due to exposure to chemicals. Common symptoms of multiple myeloma involve bone pain, broken bones, usually in the spine, feeling weak and very tired, feeling very thirsty, often infections and fevers, weight loss, nausea or constipation and urination. Treatment for multiple myeloma is focused on disease containment and suppression. Bisphosphonate therapy serves as prophylaxis against skeletal events. Chemotherapy and radiation therapy may be performed to relieve bone pain or treat a bone tumor. Bone marrow transplantation in younger patients has been shown to increase disease-free and overall survival, but it has significant risks.
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