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What Is Multiple Myeloma?

Multiple myeloma is a hematologic cancer that begins in plasma cells, a type of white blood cell that makes antibodies to protect against infection.

Normal plasma cells are an important part of the immune system and are found in the bone marrow. In multiple myeloma, cancerous plasma cells, called myeloma cells, crowd out normal plasma cells, healthy red blood cells, white blood cells, and platelets. Instead of normal antibodies, these cancerous plasma cells produce too many identical copies of an antibody called monoclonal protein, or M-protein. M-protein can cause complications such as bone tumors, kidney damage, low blood counts, and immune compromise.

According to the American Cancer Society, approximately 34,920 new cases of multiple myeloma are diagnosed in the United States each year, with an estimated 12,410 deaths. In Colorado, there are an estimated 490 new cases diagnosed annually and 200 deaths.

Multiple Myeloma Prognosis and Survival Rates

The American Cancer Society tracks five-year survival rates for multiple myeloma using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. This data groups cancers into localized, regional, and distant stages. At the localized stage, only one tumor, called a solitary plasmacytoma, is growing in or outside the bone. At the distant stage, multiple tumors are found, leading to the diagnosis of multiple myeloma. The staging of multiple myeloma does not depend on the number or location of tumors like solid tumors, but rather on genetic factors in the tumors and other blood markers that signify tumor aggressiveness.

Currently, with optimal treatment including autologous stem cell transplant and lenalidomide maintenance, the average survival is nearly 10 years. 

Why Come to CU Cancer Center for Multiple Myeloma

The CU Cancer Center is the only National Cancer Institute-Designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region. 

CU Cancer Center researchers and physicians are world leaders in blood cancer breakthroughs and the best in the Rocky Mountain region for stem cell transplant outcomes. 

Patients also may be eligible for ongoing clinical trials, which provide additional options along with transitional multiple myeloma treatments. CU Cancer Center physicians are leaders in stem cell and bone marrow transplants for multiple myeloma. They also are on the cutting edge of research and have made exciting breakthroughs in developing immunotherapies for multiple myeloma.

Our clinical partnership with UCHealth has produced survival rates higher than the state average for all stages of multiple myeloma.

Multiple Myeloma Cancer Graph

Number of Patients Diagnosed – UCHealth 232 – State of Colorado 1,257
Number of Patients Surviving – UCHealth 125 – State of Colorado 641
*n<30, 5 Year Survival – (Date of diagnosis 1/1/2010–12/31/2014)

Risk Factors for Multiple Myeloma

In the past few decades, researchers have made significant progress in understanding how certain changes to DNA can cause plasma cells to become cancerous. In about half of people with myeloma, part of one chromosome switches with part of another chromosome in myeloma cells, a form of mutation that is called a translocation.

Types of Multiple Myeloma

While there is a spectrum of plasma cell disorders, only when plasma cells grow uncontrollably and cause symptoms is the condition considered active multiple myeloma. The plasma cell disorders that may not meet the criteria to be considered active multiple myeloma include:

  • Monoclonal gammopathy of undetermined significance (MGUS), which occurs when clonal plasma cells make up less than 10% of cells in the bone marrow. MGUS is generally considered a precancerous condition and has no symptoms. There is a low risk of advancing to active disease for most patients with MGUS.
  • Smoldering multiple myeloma (SMM) is also considered precancerous, but the clonal plasma cells make up greater than 10% of the bone marrow. SMM is also asymptomatic. Patients with SMM are more likely to progress to active myeloma than patients with MGUS.
  • Solitary plasmacytoma is a single tumor that develops in a bone or other tissue but has not spread to other parts of the body. This condition is typically curable by surgery or radiation treatment.
  • Light chain amyloidosis occurs when clonal plasma cells produce an antibody protein that tends to deposit in patient tissues, causing a variety of potential complications. 

Active multiple myeloma is generally diagnosed with higher levels of plasma cells in the bone marrow and symptoms that comprise the CRAB criteria: calcium elevation, renal dysfunction, anemia, and bone disease, such as bone lesions. 

Risk Factors for Multiple Myeloma

There are several risk factors that may affect a person’s chance of being diagnosed with multiple myeloma, though it is important to remember that risk factors don’t tell the entire story of cancer. 

For multiple myeloma, risk factors can include:

  • Age: The risk of being diagnosed with multiple myeloma increases with age, and fewer than 1% of cases are diagnosed in those 35 or younger. The majority of cases are diagnosed in those age 65 or older.
  • Gender: Males have a slightly greater chance of developing multiple myeloma than females.
  • Race: Multiple myeloma is found almost twice as often in people who are Black than in people who are White, and the reasons for this are unknown.
  • Weight: People who are overweight or obese are at increased risk for developing multiple myeloma.
  • Family history: There is evidence that people who have siblings or parents diagnosed with multiple myeloma are slightly more likely to be diagnosed than people without that family history. However, the vast majority of patients with multiple myeloma have no family history of the disease.

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Information reviewed by Dan Sherbenou, MD, PhD, in May 2022.