NCCN Guidelines for Patients® | Multiple Myeloma

12 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 Symptoms of myeloma In a healthy person, there are plenty of normal blood cells and normal amounts of all five types of antibodies. In a person with myeloma, fewer normal blood cells are made when the bone marrow is full of myeloma cells. Likewise, normal antibodies are outnumbered by the one type of abnormal antibody—M-protein—made by the myeloma cells. As a result, symptoms of the myeloma will appear. When myeloma is causing symptoms or affecting organs, it is called active (symptomatic) myeloma . Symptomatic myeloma should be treated. Even without symptoms or damage to body organs, myeloma with certain lab test results that suggest it will soon cause symptoms also requires treatment. Such lab test results include the amount of plasma cells in the bone marrow, the amount of abnormal light chain, and the number of painless bone lesions. When myeloma isn’t causing symptoms and does not have lab test results that require treatment, it is called smoldering (asymptomatic) myeloma . Patients may also have small amounts of M-protein and smaller numbers of abnormal plasma cells in the bone marrow without any symptoms, a condition referred to as MGUS ( m onoclonal g ammopathy of u ndetermined s ignificance). Some of the most common symptoms of active myeloma are described next. Fatigue and feeling weak Fatigue is severe tiredness despite getting enough sleep and rest. Fatigue and feeling weak are symptoms of anemia. Anemia is a condition in which the amount of hemoglobin in the red blood cells is low. Anemia can be caused by too many myeloma cells crowding out growing red blood cells in the bone marrow. 1 Multiple myeloma Symptoms of myeloma Figure 5 Common areas of bone damage by myeloma Myeloma cells can damage bone. This damage can cause bones to break (fracture) easily. Common sites of bone damage from myeloma are the spine, skull, hip bone, ribs, arms, and collarbone. Ribs Spine Hip bone Skull Figure 1.5 Co mon areas of bone damage by myeloma Illustration Copyright © 2019 Nucleus Medical Media, All rights reserved.