International Myeloma Foundation
Multiple Myeloma
Cancer in the Bone Marrow
Myeloma is a cancer in the bone marrow affecting blood production.
ultiple myeloma has
It is also called "multiple myeloma", because it affects multiple
gone from being a
M
areas of bone marrow and tumors destroy surrounding bone.
death sentence to a
disease that's not yet
curable, but very
Overview
treatable. Patients can
Myeloma is the second most common blood cancer after lymphomas, affecting an
now expect to live many
estimated 750,000 people worldwide, and its prevalence is increasing.
years with this disease.
Myeloma is INCURABLE but HIGHLY TREATABLE, with more than 100 drug regimens in
Dr. Brian Durie
clinical trials in the United States.
Chairman, International
Myeloma Foundation
Myeloma specifically affects plasma cells (antibody-producing lymphocytes) within
the bone marrow, resulting in:
ˇ Anemia
ˇ Destruction of bone tissue
ˇ Reduced immune function
ˇ Kidney failure
ˇ Build-up of M protein (an antibody that is not needed and can cause
Prognosis
thickening of the blood)
Determined by the number
Symptoms include pain of varying intensity, often in the lower back or ribs with
of myeloma cells plus
fractures occurring either spontaneously or following trivial injury. Patients have
their specific properties
an increased risk of infection. General malaise is frequent; significant weight loss
such as rate of growth.
is rare.
In 2005 the International
The causes of myeloma have been extensively investigated. Several causes have been
Myeloma Working Group,
identified, including toxic chemicals, radiation, several viruses, as well as physical and
sponsored by the IMF,
psychological stress factors.
developed a new STAGING
system, the International
Myeloma Is an Important Focal Point
Staging System (ISS) that
for Advanced Cancer Research
correlates key factors that
affect prognosis. The ISS
has been introduced for
Although once considered a death sentence with limited options for treatment, today
widespread use.
there are more than 100 drugs in clinical trials in the United States alone, and multiple
drug regimens can be used in sequence to help some patients maintain their daily
routines for years and even decades.
The most widely prescribed drug for
Thalidomide was responsible for an
myeloma is THALIDOMIDE, an anti-cancer
epidemic of birth defects in Europe
drug that can be taken by mouth.
in the 1950's. Today it is an example
of the new inroads being made in the
Thalidomide, a related drug called
fight against cancer:
REVLIMIDŽ, and VELCADEŽ, a first-in-class
his is an exciting time
T
medication, show evidence of improved
halidomide has the ability not
in myeloma research,
T
survival in clinical trials. All three are
only to kill the tumor cell
with new agents and
often used in combination with a steroid,
directly, but also to act in the bone
new approaches coming
marrow to make it impossible for
dexamethasone, and they are being
to light at an
the myeloma cell to grow and
studied for use in sequence and in various
unprecedented pace.
survive there.
combinations, so each time patients
Dr. Ken Anderson
Susie Novis
relapse there is a new regimen waiting
Dana-Farber Cancer Institute
Founder and President of
for them to try.
the International
Myeloma Foundation
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.
20060824
International Myeloma Foundation
Multiple Myeloma
Cancer in the Bone Marrow
Well-Known Patients
Multiple Myeloma Statistics
Myeloma (MM) represents approximately 1% of all cancers
Don Baylor and Mel Stottlemyre,
Internationally, the incidence varies from <1/100,000 people
former Major League Baseball
in China, to 3-4/100,000 in the U.S. and most Western
players turned coaches, have been
industrialized countries
diagnosed with multiple myeloma.
50,000 Americans currently have MM
Both continued to coach after their
diagnosis.
An estimated 15,000 new cases are diagnosed each year in the U.S.
Approximately 11,000 Americans die from MM every year
Geraldine Ferraro, the first woman
The median age of diagnosis is approximately 65 years
to run for vice-president in the U.S.,
The five-year survival rate of patients ranges from 10% to 50%.
was diagnosed in 1998. In 2005 she
However, with newer treatments, some patients live 10 to 20 years
became the first patient to donate
or longer, especially those diagnosed at <50 years of age.
a DNA sample to Bank on a CureŽ,
The male/female ratio is 3:2
The IMF gene bank for the study of
myeloma.
MM is twice as common in African Americans as in Caucasians
Movie actor Roy Scheider was
Pathology
diagnosed with multiple myeloma
Multiple myeloma is a cancer in which plasma cells important
and underwent a bone marrow
components of the immune system grow and divide in an uncontrollable
transplant in June, 2005.
fashion and accumulate in the bone marrow. Normal plasma cells make
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 immunoglobulin
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
Commonly used regimens for initial therapy include
Newer treatments include Velcade, thalidomide and
bisphosphonates (drugs that counter the ill effects of MM on
Revlimid, alone and in combination, for newly diagnosed
the bones), steroids such as dexamethasone, combination
and for relapsed patients. (See previous page.) Doxil,
regimens such as VAD (vincristine, doxorubicin and
fat bubbles called liposomes that contain doxorubicin,
dexamethasone) and alkylating agents such as melphalan.
a drug that has been used to treat cancer for over
Stem cell transplantation is performed to replace
20 years. Doxil is being studied in combination with
bone marrow cells after a patient receives high-dose
Velcade, thalidomide and other drugs. And Skeletal
chemotherapy, which destroys cancerous cells and normal
Targeted Radiotherapy (STRTM) is designed to be used in
cells alike. This approach improves survival, but is not
combination with high-dose chemotherapy producing a
curative since 90% of patients ultimately relapse. It may
direct therapeutic effect on the tumor sites in the bone
take three months to a year to recover from an autologous
plus a general bone-marrow effect.
transplant, one that uses cells taken from the patient's
own bone marrow.
"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.
20060824