Understanding Multiple Myeloma

Multiple myeloma (MM) is a plasma cell dyscrasia characterized by the proliferation of malignant cells in the bone marrow (Porth, 2009). Also known as plasma cell myeloma, myelomatosis, medullary plasmacytosis or Kahler’s disease, MM results from the development of a monoclonal immunoglobulin (referred to as an M-protein), a monoclonal immunoglobulin light chain, or both (Ferreira, 2013). Patients with MM can present with a wide range of signs and symptoms including bone fractures, anemia and kidney damage or no symptoms at all (Lobban & Perkins, 2013). This creates a diagnostic challenge to clinicians as many of these conditions are of benign etiology (Lobban & Perkins, 2013). The individual variations among patients with this diagnosis also contributes to a complex treatment plan which can include chemotherapy, stem cell transplant, and supportive therapy for comorbidities (Lobban & Perkins, 2013). There is no cure for MM, but recent advances in treatment modalities have been shown to prolong survival and improve quality of life (Lobban & Perkins, 2013).

MM is the second most common blood cancer and the most common primary bone malignancy (Kaufman, 2007). It accounts for 10% of all hematologic malignancies and 1% of all cancers (Porth, 2009). It occurs most frequently in people older than 60 years of age, with a mean diagnosis between 65 and 68 years (Kaufman, 2007). Only 2% of MM cases are identified in patients younger than 40 years and 5% under patients under 50 years (Kelly, Meenaghan, & Dowling, 2010). MM incidence is greater in men than in women, and twice as common in African Americans as Caucasians (Ferreira, 2013). There also seems to be a familial connection as the risk of MM is 3.7 times as ...

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... Myeloma: making sense of a complex blood cancer. British Journal of Nursing, 19(22), 1415-1421.

Lobban, L. & Perkins, S. (2013). Role of the specialist nurse in caring for patients with myeloma. Nursing Standard, 28(5), 37-41.

Porth, C.M. (2009). Disorders of white blood cells and lymphoid tissues. In C.M. Porth and G. Matfin (Eds.), Pathophysiology: Concepts of Altered Health States, (8th ed., pp. 301-321). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Seiter, K. & Shah, D. (2013). Multiple myeloma differential diagnoses. Medscape. Retrieved from http://emedicine.medscape.com/article/204369-differential

Sommer, C. (2009). Innate and adaptive immunity. In C.M. Porth and G. Matfin (Eds.), Pathophysiology: Concepts of Altered Health States, (8th ed., pp. 347-376). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.