International Myeloma Foundation
Multiple Myeloma
Cancer of Plasma Cells in the Bone Marrow
Myeloma is a cancer of the bone marrow affecting production of red
"MULTIPLE MYELOMA has gone
cells white cells and stem cells, and it can damage bone.
from being a death sentence
to a disease that's not
It is also called "multiple myeloma," because
yet curable, but falls
multiple areas of bone marrow may be involved.
into the category of
being a very treatable
Overview
disease, a manageable
disease over the course
of many years."
Myeloma is the second most common blood cancer after lymphomas, affecting
an estimated 750,000 people worldwide and in industrialized countries it is being
Dr. Brian Durie
diagnosed in growing numbers and in increasingly younger people.
Chairman, International
Myeloma Foundation
Myeloma is INCURABLE but HIGHLY TREATABLE, with more than 100 drug regimens in
clinical trials in the United States.
Myeloma specifically affects plasma cells (antibody-producing lymphocytes) within
the bone marrow, resulting in:
·
Anemia
·
Destruction of bone tissue
PROGNOSIS
·
Reduced immune function
is determined by the
·
Kidney failure
number of myeloma cells
·
Build-up of M protein (an antibody that is not needed and can cause
plus their specific properties
thickening of the blood)
such as rate of growth.
Symptoms include pain of varying intensity, often in the lower back or ribs with
In 2005 the International
fractures occurring either spontaneously or following trivial injury. Patients have
Myeloma Working Group,
an increased risk of infection. General malaise is frequent; significant weight loss
sponsored by the IMF,
is rare.
developed a new STAGING
system, the International
Although myeloma was once considered a death sentence with limited options for
Staging System (ISS) that
treatment, today there are more than 100 drugs in clinical trials in the United States
correlates key factors that
alone, and multiple drug regimens can be used in combination and in sequence to
affect prognosis. The ISS has
help some patients maintain their daily routines for years and even decades (see
been introduced for
next page).
widespread use.
Possible Causes New Findings
The causes of myeloma have been extensively investigated. Several possible causes
have been identified, including toxic chemicals, radiation, several viruses, as well
This is an exciting time in
as physical and psychological stress factors.
myeloma research, with
new agents and new
In July 2009, a published study from researchers with the IMF gene bank Bank On A
approaches coming
Cure®, identified several changes in DNA sequences called SNPs (single nucleotide
to light at an
polymorphisms) that are associated with a risk of bone disease in myeloma. Further
unprecedented pace."
analyses showed that many of these DNA changes may be involved with the way the
Susie Novis
human body responds to certain toxins, providing a possible link between myeloma
Founder and President of
and environmental contamination.
the International
Myeloma Foundation
This may help explain why myeloma is increasingly being diagnosed in patients
under 45 years old, including some of the early responders to the 9/11 World Trade
Center site.
20090916
International Myeloma Foundation
Multiple Myeloma
Cancer in the Bone Marrow
Well-Known Patients
Multiple Myeloma Statistics
Movie and television star Peter
Boyle died from complications
Myeloma (MM) represents approximately 1% of all cancers
of myeloma in December 2006.
In the U.S. and most Western industrialized countries the incidence is
His family and his colleagues
3-4/100,000 people
have established the Peter Boyle
50,000 100,000 Americans currently have MM
Memorial Fund to support the IMF.
Approximately 20,000 new cases are diagnosed each year in the U.S.
Approximately 11,000 Americans die from MM every year
Don Baylor and Mel Stottlemyre,
former Major League Baseball
The median age of diagnosis is approximately 65 years
players turned coaches, have
The five-year survival rate of patients ranges from 10% to 50%.
been diagnosed with multiple
However, with newer treatments, some patients live 10 to 20 years
myeloma. Both continued to
or longer.
coach after their diagnoses.
The male/female ratio is 3:2
MM is twice as common in African Americans as in Caucasians
Geraldine Ferraro, the first woman
to run for vice-president in the
U.S., was diagnosed in 1998. In
Pathology
2005 she became the first patient
Multiple myeloma is a cancer in which plasma cells important
to donate a DNA sample to Bank On
components of the immune system grow and divide in an uncontrollable
A Cure®, The IMF gene bank for the
fashion and accumulate in the bone marrow. Normal plasma cells make
study of myeloma.
antibodies, or immunoglobulins, that help to fight disease. Myeloma cells
also produce the same type of immunoglobulin protein, but this abnormal
protein (M-protein) does not help protect the body from infection. In
addition, the M protein that is produced can build up in organs such as
the kidneys, causing serious damage over time.
Bence Jones Proteins: Myeloma cells produce incomplete immuno--
globulin molecules (light chains) that can adhere to each other and to
other tissues, and become deposited in tissues and in small blood vessels
such as in the kidneys.
MGUS: Monoclonal Gammopathy of Undetermined Significance is
asymptomatic myeloma. It should be observed rather than treated.
Treatment
Newer treatments include the "novel therapies,"
These approaches extend survival, but are not curative
REVLIMID®, VELCADE® and THALOMID® (thalidomide).
since patients relapse. Physicians may move patients
They are often used in combination with the steroid
through various treatment regimens in sequence to
dexamethasone, or the alkylating agent Melphalan with
generate back-to-back remissions.
the steroid prednisone. REVLIMID is the first in a class of
drugs called immunmodulatory drugs or IMiDs® compounds.
"Next-generation" drugs are under development and
REVLIMID and THALOMID act in the microenvironment of
include pomalidomide and carfilzomib. Other treatments
the cancer cells and are oral drugs. VELCADE for injection
include DOXIL - doxorubicin, a drug that has been used to
is the first in a new class of medicines called proteasome
treat cancer for over 20 years that has been reformulated
inhibitors that disrupt the life cycle of a cancer cell.
to be contained in fat bubbles called liposomes. Multiple
drugs are used to treat the bone damage associated with
Autologous stem cell transplants use cells taken from the
multiple myeloma.
patient's own bone marrow. The cancerous bone marrow
cells are treated with high-dose chemotherapy to eradicate
the cancer and then returned to the patient.
"Until there is a cure... There is the IMF."
Additional information can be found at www.myeloma.org.
The International Myeloma Foundation is a not-for-profit organization supporting research and providing
education, advocacy and support for myeloma patients, families, researchers and physicians.
20091214