Sept. 27, 2010 | Multiple myeloma is a cancer of plasma cells, a type of white cell. Plasma cells are found primarily in the bone marrow. Normal plasma cells are formed from B lymphocytes. In myeloma, a developing plasma cell becomes malignant. Eventually, the number of malignant plasma cells, or myeloma cells, increases, especially in the marrow and sometimes other sites in the body, disrupting normal blood cell production, destroying normal bone tissue and causing pain. The onset of myeloma interferes with normal plasma cell production of proteins called immunoglobulins. Immunoglobulins are an important part of the body’s natural defense against infection. They recognize and destroy microbes that invade the body. Myeloma cells produce an abnormal immunoglobulin called M protein, for monoclonal immunoglobulin, which does not protect the body against infection. It’s for this reason that patients like those at the UAMS Myeloma Institute for Research and Therapy are susceptible to infections and other serious complications.

Sept. 27, 2010 | An estimated 20,180 new cases of multiple myeloma, 11,170 men and 9,010 women, are expected to be diagnosed in the United States this year, according to the Leukemia and Lymphoma Society. The median age at diagnosis is 70 years of age, and it rarely occurs in people under age 45. Americans of African descent have a much higher incidence rate of myeloma, 11.7 per 100,000 individuals, than those of European descent, 5.2 per 100,000. Bone pain, which occurs because of the effects of myeloma cells on the marrow, is often the first symptom of myeloma. Fractures may occur as a result of weakened bones. Additional early signs and symptoms of the disease may include anemia, recurrent infections or numbness or pain in the hands and or feet, caused by a condition called “peripheral neuropathy”. People with myeloma may have no symptoms or they may tire more easily and feel weak. An estimated 69,598 people are currently living with, or are in remission from, myeloma in the United States.

Sept. 27, 2010 | There are a number of ways to treat multiple myeloma, all of which are available at the Myeloma Institute for Research and Therapy here at UAMS. The goal in treating multiple myeloma is to control the disease’s growth, to achieve remission, improve the patient’s quality of life, and prolong survival. Treatment is typically begun when there are overt symptoms from the disease. Chemotherapy involves using medicine – taken orally as a pill or given through an intravenous injection – to kill myeloma cells. Stem cell transplantation involves using high-dose chemotherapy along with transfusion of previously collected immature blood cells to replace diseased or damaged marrow. Radiation therapy uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area, for instance, to shrink a tumor that’s causing pain or destroying a bone. The Myeloma Institute has also found success in using anti-cancer drugs, administered at home or on an outpatient basis.

Sept. 27, 2010 | The UAMS Myeloma Institute for Research and Therapy is the only facility in the world that routinely offers gene array analysis for newly referred patients and utilizes this information for patient management and planning of therapy. The institute, which treats more myeloma patients than any other cancer center in the world, performs multiple gene arrays on every patient enrolled on a clinical protocol. Based on a study of more than 500 newly diagnosed patients treated at the institute for multiple myeloma, researchers found that the expression of just 17 genes, out of the 25,000 genes in the human body, revealed which form of myeloma a patient had. The expression level of those 17 genes serves as a powerful predictor of response to therapy. This enables doctors to more accurately predict which patients will not respond to standard therapy and thereby spare patients from undergoing treatments that will not be effective. The discovery is also important to the development of new treatments that specifically target the 17 genes.

Sept. 27, 2010 | The immediate goal in treating multiple myeloma is to get the disease under control and to keep the patient in remission with a good quality of life for as long as possible. Disease control can be complicated by a tendency for myeloma cells to become resistant to chemotherapeutic agents. Lengthy remissions can often be achieved, especially in cases of low-risk disease as defined by genetic profiling. The number of patients who can be considered cured is steadily increasing. A patient diagnosed with low-risk multiple myeloma who is treated at the UAMS Myeloma Institute for Research and Therapy can expect to survive more than 10 years. Treatment outcomes vary, even among patients with the same diagnosis. Individuals are encouraged to talk to their physicians for more information. Newer agents and drug combinations, progress in stem cell transplantation, better supportive care and studies of new drugs in clinical trials are all contributing to improved outcomes and quality of life for people with myeloma.