When To Speak To Your Gp
Speak to your GP if you have any of these symptoms. While they’re unlikely to be caused by cancer, it’s best to get a proper diagnosis.
Your GP will examine you to check for bone tenderness, bleeding, signs of infection, and any other symptoms that suggest you may have myeloma.
They may also arrange blood and urine tests that can detect abnormal proteins produced by myeloma cells.
If myeloma is suspected, you will be referred to a consultant haematologist for further tests and treatment.
Read more about diagnosing multiple myeloma
Support Groups For Multiple Myeloma
If you’ve been diagnosed with multiple myeloma, you may want to contact a local or national support group, such as Myeloma UK.
Your local haematology team will be able to direct you to helpful resources.
Support groups can offer more information and advice. They can also often put you in touch with other people in a similar situation so you can share advice and talk about your experiences.
Bringing Myeloma Under Control
The initial treatment for multiple myeloma may be either:
- non-intensive for older or less fit patients
- intensive for younger or fitter patients
The decision about which treatment is appropriate for you is usually based on your biological age or fitness.
As a general rule, people younger than 65 are more likely to be candidates for intensive therapy. For those over 70, non-intensive treatment is more likely to be recommended.
Those aged in between will be given careful consideration as to what treatment group they fall into.
Both non-intensive and intensive treatments involve taking a combination of anti-myeloma medicines. Intensive treatment involves much higher doses and is followed by a stem cell transplant.
The medicines usually include a chemotherapy medicine, a steroid medicine, and either thalidomide or bortezomib.
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Signs And Symptoms Of Light Chain Amyloidosis
Patients with amyloidosis can have some of the same problems as patients with myeloma, such as kidney problems and nerve damage. They can also have other problems, such as:
- Heart problems: The heart may enlarge and become weaker. In some people, the heart becomes so weak that fluid builds up in the lungs, making them feel short of breath. Fluid may also build up in the legs and feet . This is called congestive heart failure.
- Enlarged liver: The person may feel the liver below the right ribs. When this gets large it can press on the stomach so the person feels full after eating only a small amount of food.
- Enlarged tongue: When amyloid builds up in the tongue it can get larger. This can lead to problems swallowing and problems breathing during sleep .
- Skin changes: Changes in the color or texture, easy bruising, and bleeding into the skin around the eyes
- Kidney problems
How Multiple Myeloma Is Treated
There is currently no cure for multiple myeloma, but treatment can often help control it for several years.
Treatment will often involve:
- a combination of anti-myeloma medications to destroy the myeloma cells
- medicines and procedures to prevent and treat problems caused by myeloma, such as bone pain, fractures and anaemia
- anti-myeloma medicines to control the cancer when it comes back
As part of your treatment, you may be asked if you want to take part in a clinical trial to help researchers develop better treatments for multiple myeloma.
Read more about treating multiple myeloma
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When To See A Gp
See a GP if you have any of the symptoms of multiple myeloma. While they’re unlikely to be caused by cancer, it’s best to get a proper diagnosis.
Your GP will examine you to check for bone tenderness, bleeding, signs of infection and any other symptoms that suggest you might have myeloma. They may also arrange blood and urine tests.
If myeloma is suspected, you’ll be referred to a consultant haematologist for further tests and treatment.
Read more about diagnosing multiple myeloma.
Metastatic Multiple Myeloma To The Skin
Douglas J. GriderAcademic Editor: Received
Abstract
Cutaneous involvement of multiple myeloma is uncommon, typically occurs in late stage disease, and is a poor prognostic indicator with an approximate eight month median survival. We present a 51-year-old man with relapsed lambda light chain MM who developed abrupt asymptomatic skin metastases. Biopsy revealed a dermis replete of atypical plasma cells, positive for CD138 and CD45. In situ hybridization confirmed lambda light chain restriction. Despite rescue antimyeloma therapy with the anti-CD38 drug daratumumab, he rapidly declined clinically and succumbed to the disease four weeks after presentation. A standard treatment approach for cutaneous MM does not currently exist however, various techniques to detect cytogenetic abnormalities are emerging and will provide additional prognostic value and direct individualized therapy.
1. Case Presentation
The patients renal failure was attributed to myeloma kidney and hemodialysis, apheresis, and daratumumab were initiated. While his encephalopathy initially improved, the patient declined clinically and he was transitioned to comfort care three weeks after the biopsy, dying 5 days later.
2. Discussion
3. Conclusion
Disclosure
This case was originally presented in 2015 as a poster at the 53rd Annual Meeting of the American Society of Dermatopathology.
Conflicts of Interest
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How Do Healthcare Providers Stage Multiple Myeloma
Healthcare providers stage multiple myeloma and other cancers to learn about the cancers size and location. Cancer staging lays the foundation for treatment. The staging process for multiple myeloma starts with placing the condition in one of four classifications:
- MGUS: Blood tests show small amounts of M protein. About 1 % to 2% of people with MGUS develop multiple myeloma.
- Solitary or isolated plasmacytomas: These are single groups of abnormal plasma cells.
- SMM: This is a pre-cancerous form of multiple myeloma. People who have SMM may have mild symptoms along with tests showing small amounts of M protein in their blood and an increased number of plasma cells in their bone marrow.
- Multiple myeloma: This classification means tests show multiple groups of abnormal plasma cells, high M protein levels in blood or urine and a high percentage of abnormal plasma cells in bone marrow. People in this classification often have anemia, hypercalcemia, kidney failure and osteolytic lesions.
Healthcare providers use the Revised International Staging System to stage multiple myeloma. The RISS system is based in part on blood tests that show the levels of albumin, beta-2 microglobulin and lactate dehydrogenase. Healthcare providers also consider tests for specific gene abnormalities.
Age Can Affect The Risk Of Plasma Cell Neoplasms
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Plasma cell neoplasms are most common in people who are middle aged or older. For multiple myeloma and plasmacytoma, other risk factors include the following:
- Having a personal history of MGUS or plasmacytoma.
- Being exposed to radiation or certain chemicals.
Studies about how racial, social, and financial factors affect access to treatment and rates of plasma cell neoplasms are ongoing.
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Does Multiple Myeloma Cause Skin Discoloration
Skin plasmacytomas usually present on lighter skin as red bumps or whitish plaques that may form ulcers. On darker skin , the bumps may appear darker red or purplish in color, and the plaques may have a grayish tone to them.
Some other skin conditions associated with myeloma can cause signs such as ulcers or symptoms such as rashes or redness.
Talk With Others Who Understand
MyMyelomaTeam is the social network for people with myeloma. On MyMyelomaTeam, more than 16,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.
Do you have myeloma with rashes or skin changes? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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What Are The Different Types Of Skin Conditions Seen In Multiple Myeloma
Multiple myeloma develops in plasma cells, a type of white blood cell that produces proteins called antibodies that tell other cells in your immune system to attack foreign invaders.
Myeloma or treatment for myeloma can cause a variety of skin conditions, including rashes, sores, and bumps. Symptoms can develop due to:
- the accumulation of plasma cells in your skin
- the buildup of abnormal M protein produced by cancer cells
- medication side effects
of plasmacytomas forming at the site of traumatic injury have also been reported.
A plasmacytoma that grows outside of your bone and bone marrow is called an extramedullary plasmacytoma. About 7 percent of people with myeloma have an extramedullary plasmacytoma when they receive their diagnosis, and another 6 to 7 percent develop one later. They tend to develop if you have aggressive or highly progressed myeloma.
Skin plasmacytomas usually present as red bumps or plaques that may form ulcers, or sores on the lining of your stomach or small intestine.
Skin Nodules In Multiple Myeloma
Blood
Skin nodules in multiple myeloma. Blood 2011 117 : 2088. doi:
A 63-year-old woman had stage IIIb IgG multiple myeloma that contained a 13q deletion by fluorescence in situ hybridization. She was treated with vincristine, adriamycin, and dexamethasone, which achieved a partial response. Three months later, there was clinical and biological progression. Despite treatment with bortezomib and dexamethasone, a plasmacytoma developed in the right scapula. Further treatment included local radiotherapy followed by autologous peripheral blood stem cell transplantation .
Three months after transplantation, rose-colored nontender nodules appeared on the skin of the right arm. A skin biopsy showed a diffuse infiltrate of plasma cells in the dermis that were strongly immunoreactive for chain . The patient died a few weeks later.
Although extramedullary relapses of myeloma are occasionally seen after PBSCT, skin involvement is a rare event.
Three months after transplantation, rose-colored nontender nodules appeared on the skin of the right arm. A skin biopsy showed a diffuse infiltrate of plasma cells in the dermis that were strongly immunoreactive for chain . The patient died a few weeks later.
Although extramedullary relapses of myeloma are occasionally seen after PBSCT, skin involvement is a rare event.
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Multiple Myeloma And Other Plasma Cell Neoplasms May Cause A Condition Called Amyloidosis
In rare cases, multiple myeloma can cause peripheral nerves and organs to fail. This may be caused by a condition called amyloidosis. Antibody proteins build up and stick together in peripheral nerves and organs, such as the kidney and heart. This can cause the nerves and organs to become stiff and unable to work the way they should.
Amyloidosis may cause the following signs and symptoms:
- Feeling very tired.
- Purple spots on the skin.
- Enlarged tongue.
- Swelling caused by fluid in your body’s tissues.
- Tingling or numbness in your legs and feet.
Blood Cells And Myeloma
To understand why myeloma affects you the way it does, it helps to understand how blood cells are normally produced and what they do.
Usually bone marrow makes blood cells in a controlled way, when your body needs them. All blood cells start as the same type of cell, called a stem cell. As they develop , they turn into one of three types of blood cell:
- white blood cells
- red blood cells
Plasma cells develop from a type of white blood cell called B lymphocytes. In myeloma, too many plasma cells are made and they are all of the same type. They crowd the bone marrow. This means that there is not enough space for making normal white cells, red cells and platelets.
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Mgus And Smoldering Multiple Myeloma
These are premalignant clonal plasma cell disorders that are diagnosed incidentally in most patients. The disorders included in this category are called MGUS and smoldering multiple myeloma. In the majority of patients, these disorders are asymptomatic and do not require treatment. However, in some patients these disorders can lead to complications, including peripheral neuropathy and renal disorders called monoclonal gammopathy of renal significance .
How Is Multiple Myeloma Treated
Treatment for multiple myeloma depends on many things, like your cancer stage, age, overall health, and test results.
Treatment also depends on which type of MM you are diagnosed withsmoldering myeloma or active myeloma. The differences between smoldering myeloma and active myeloma are:
- Smoldering multiple myeloma: This is an early form of MM. There will be no symptoms yet . For the most part, your blood counts, kidney function, calcium levels, and bones/organs will be normal, but you may have other signs of myeloma in your body, such as:
- Too many plasma cells in your bone marrow.
- A high level of monoclonal immunoglobulin in your blood.
- A high level of light chains in your urine.
Patients with smoldering myeloma should be followed closely, without treatment. Research studies have found that treating asymptomatic myeloma does not improve long-term survival.
- Chemotherapy and other medications.
- Clinical Trials.
Chemotherapy and Other Medications
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What Are The Symptoms Of End
End-stage multiple myeloma is a devastating situation for the patient and the family. The patient suffers a lot due to the problems of multiple myeloma and seeing the patient in this stage would be a sad situation to the family.
It is important to recognize the end-stage multiple myeloma so, that the healthcare professionals and family members can focus on palliative treatment and improve quality of life rather than treating multiple myeloma. Its sometimes difficult to recognize the end-stage of multiple myeloma with the new treatment methods and clinical trials therefore sometimes patients will be on treatment for multiple myeloma during their final days. Some patients are diagnosed at a late stage and they can be in the end-stage of multiple myeloma during the initial diagnosis.
Following are some features to recognize multiple myeloma
- Multiple relapses with reduced length of remission
- Refractory disease
- Not tolerating further treatment
- Deteriorating in functional status
When end-stage is confirmed the patient and family should be informed and necessary measures should be taken to make the patients quality of life better and allow the patient to have a peaceful death.
What Are Treatment Side Effects
Cancer treatment such as chemo and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting.
Talk with your healthcare provider about side effects linked to your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.
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How Does Myeloma Develop
Myeloma develops when there is a change in the DNA of the plasma cells. DNA is the instructions for the cell so it knows what to do and when. The change happens to the DNA when the bone marrow is making new plasma cells. The abnormal plasma cell then produces more abnormal cells. These are myeloma cells.
The myeloma cells produce an abnormal form of one of the types of antibody. You might hear your doctor call the antibodies abnormal proteins, paraproteins, monoclonal proteins, or a monoclonal spike. They aren’t able to work normally and so can’t help fight infections.
The paraprotein is often found in the blood and urine if you have myeloma. Blood and urine tests are a way of diagnosing and monitoring myeloma. As well as the whole antibody , often a small part called the free light chain is also made in large amounts by the myeloma plasma cells.
Myeloma doesn’t form a lump or a tumour. Most of the problems it causes are because of a build up of abnormal plasma cells in the bone marrow and the paraprotein in the body. Myeloma affects areas where you have active bone marrow. This includes your arms and legs and your shoulders as well as your spine, skull, pelvis and rib cage. Myeloma affects several places in the body which is why it is sometimes called multiple myeloma.
This video is about myeloma. It lasts for 2 minutes and 58 seconds.
Rashes And Skin Changes With Myeloma
Multiple myeloma is a type of cancer that affects white blood cells, specifically plasma cells. Myeloma rarely causes rashes or skin changes directly. Skin problems in people diagnosed with myeloma are usually a result of treatments or complications of blood cancer. One of the biggest complications lies in the fact that myeloma disrupts and weakens the immune system.
Understanding potential symptoms and causes of skin problems and how they can be managed can help people with myeloma protect their skin, manage any skin issues, and know when its time to speak with a doctor.
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How Is It Diagnosed
Blood tests can check for many red flags, like low blood cell counts and high calcium levels. Then an SPEP and UPEP are done with immunofixation. These are serum tests that tell you if there is a monoclonal antibody present. If monoclonal antibody is found, then a bone marrow is done. But the most important test for this cancer is a bone marrow biopsy. A doctor will insert a special needle into your bone and remove a tiny piece of tissue. They’ll look at it with a microscope to see if you have myeloma cells.