Multiple Myeloma Health Article

Prognosis

The prognosis for individuals with MGUS or solitary plasmacytoma is very good. Most do not develop multiple myeloma. However, approximately 15% of all patients with multiple myeloma die within three months of diagnosis. About 60% respond to treatment and live for an average of two and a half to three years following diagnosis. Approximately 23% of patients die of other illnesses associated with advanced age.

The prognosis for a given individual may be based on the prognostic indicators described above. The median survival for those without plasmablasts, and with a low plasma cell labeling index (PCLI) and low beta 2-microglobulin, is 5.5 years. The median survival for patients with plasmablastic multiple myeloma, or with a high PCLI (1% or greater) and high beta 2-microglobulin (4 or higher), is 1.9 and 2.4 years, respectively. Many multiple myeloma patients are missing part or all of chromosome 13. The deletion of this chromosome, along with high beta 2-microglobulin, leads to a poor prognosis.

With treatment, multiple myeloma may go into complete remission. This is defined as:

• M-protein absent from the blood and urine
• myeloma cells not detectable in the bone marrow
• no clinical symptoms
• negative laboratory tests

However, with very sensitive testing, a few myeloma cells are usually detectable and eventually lead to a recurrence of the disease, in the bone or elsewhere in the body.

Prevention

There are no clearly-established risk factors for multiple myeloma and it is possible that a combination of factors interact to cause the disease. Thus, there is no method for preventing multiple myeloma.

BOOKS

Drum, David. Making the Chemotherapy Decision, 2nd ed. Los Angeles: Lowell House, 1996.

Holland, Jimmie C., and Sheldon Lewis. The Human Side of Cancer: Living with Hope, Coping with Uncertainty. New York: HarperCollins, 2000.

Longo, Dan L. "Plasma Cell Disorders." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998.

Malpas, James S., D. E. Bergsagel, R. A. Kyle, et al, eds. Myeloma: Biology and Management, 2nd ed. Oxford: Oxford University Press, 1998.

ORGANIZATIONS

International Myeloma Foundation. 12650 Riverside Dr., Suite 206, North Hollywood, CA 91607. (800) 452-CURE. (818) 487-7455. <http://www.myeloma.org>. Information and support for patients and families and the scientific and medical communities.

The Leukemia and Lymphoma Society. 600 Third Avenue, New York, NY 10016. (800) 955-4572. (914) 949-5213. <http://www.leukemia-lymphoma.org>. Information, support, and guidance for patients and health care professionals.

Multiple Myeloma Research Foundation. 11 Forest Street, New Canaan, CT 06840. (203) 972-1250. <http://www.multiplemyeloma.org>. Information and research funding.

OTHER

"About Myeloma." Multiple Myeloma Research Foundation. 16 Apr. 2001. 15 June 2001 <http://www.multiplemyeloma. org/aboutmyeloma.html>.

Complementary and Alternative Therapies for Leukemia, Lymphoma, Hodgkin's Disease and Myeloma. The Leukemia and Lymphoma Society. 27 Mar. 2001. 15 June 2001 <http://www.leukemia-lymphoma.org>.

Facts and Statistics About Leukemia, Lymphoma, Hodgkin's Disease and Myeloma. The Leukemia and Lymphoma Society. 27 Mar. 2001. 15 Mar. 2001. <http://www.leukemia-lymphoma.org>.

"Multiple Myeloma." Cancer Resource Center. American Cancer Society. 16 Apr. 2001. 15 June 2001 <http://www3.cancer.org/cancerinfo>.

"Multiple Myeloma and Other Plasma Cell Neoplasms." CancerNet National Cancer Institute. Mar. 2001. 16 Apr.2001. <http://cancernet.nci.nih.gov>.

Margaret Alic, Ph.D.

KEY TERMS

Amyloidosis—A complication of multiple myeloma in which amyloid protein accumulates in the kidneys and other organs, tissues, and blood vessels.

Anemia—Any condition in which the red blood cell count is below normal.

Antibody—Immunoglobulin produced by immune system cells that recognizes and binds to a specific foreign substance (antigen).

Antigen—Foreign substance that is recognized by a specific antibody.

B-cell (B-lymphocyte)—Type of white blood cell that produces antibodies.

Bence-Jones protein—Light chain of an immuno-globulin that is overproduced in multiple myeloma and is excreted in the urine.

Beta 2-microglobulin—Protein produced by B-cells; high concentrations in the blood are indicative of multiple myeloma.

Cryoglobulinemia—Condition in which protein in the blood forms particles in the cold, blocking blood vessels, leading to pain and numbness of the extremities.

Electrophoresis—Use of an electrical field to separate proteins in a mixture (such as blood or urine), on the basis of the size and electrical charge of the proteins.

Hemoglobin—Protein in red blood cells that carries oxygen.

Hypercalcemia—Abnormally high levels of calcium in the blood.

Hyperviscosity—Thick, viscous blood, caused by the accumulation of large proteins, such as immunoglobulins, in the serum.

Immunoglobulin (Ig)—Antibody; large protein produced by B-cells that recognizes and binds to a specific antigen.

M-protein—Monoclonal or myeloma protein; paraprotein; abnormal antibody found in large amounts in the blood and urine of individuals with multiple myeloma.

Malignant—A characteristic of cancer cells that grow uncontrollably and invade other tissues.

Monoclonal—Identical cells or proteins; cells (clones) derived from a single, genetically-distinct cell, or proteins produced by these cells.

Monoclonal gammopathy of undetermined significance (MGUS)—Common condition in which M-protein is present, but there are no tumors or other symptoms of disease.

Neoplasm—Tumor or abnormal tissue, made up of rapidly growing cells.

Osteoblast—Bone-forming cell.

Osteoclast—Cell that absorbs bone.

Osteolytic lesion—Soft spot or hole in bone caused by cancer cells.

Osteoporosis—Condition in which the bones become weak and porous, due to loss of calcium and destruction of cells.

Paraprotein—M-protein; abnormal immunoglobulin produced in multiple myeloma.

Plasma cell—Type of white blood cell that produces antibodies; derived from an antigen-specific B-cell.

Platelet—Cell that is involved in blood clotting.

Stem cell—Undifferentiated cell that retains the ability to develop into any one of numerous cell types.