Myeloma is a type of cancer that affects a type of white blood cell called a B-cell. It generally begins in the bone marrow, and can spread from one location to another. The cancerous cells often appear in multiple patches in the bone marrow, which is why the disease is often called multiple myeloma.
The symptoms of myeloma vary from patient to patient. In the early stages, symptoms may be mild and seem unconnected to each other.
Myeloma patients may experience bone pain in any bone, though the areas most commonly affected are the back, hips, and skull. Bones are often weakened by the disease, and patients may develop osteoporosis. As a result, bones may become more fragile and break easily.
As a result of bone marrow changes, the number of cells made in the marrow also changes. The cells that are made are often abnormal. Patients may have shortages of red blood cells, white blood cells, and platelets.
The loss of these cells can cause symptoms including anemia (in which the loss of red blood cells causes weakness, shortness of breath, and dizziness), thrombocytopenia (in which loss of platelets causing serious bleeding from even minor injuries), and leukopenia (loss of white blood cells may make people more susceptible to infections).
The growth of tumors in the bone marrow may mean that excess calcium is released from damaged bones. This may cause high levels of calcium in the blood (hypercalcemia), leading to symptoms including extreme thirst, dehydration, kidney problems, constipation, stomach pain, weakness, and confusion. In severe cases, hypercalcemia can lead to coma.
In some patients, large quantities of protein produced by myeloma cells can cause the blood to become thick. This is called hyperviscosity, and it can slow the blood flow to the brain, which may cause confusion, dizziness, and stroke-like symptoms.
Nervous system symptoms
If the bones of the spine are weakened by myeloma, they can press on spinal nerves. This can cause severe back pain, muscle weakness, and numbness in the legs or arms. In cases when these symptoms appear suddenly, patients should seek immediate medical attention.
The abnormal proteins produced by myeloma cells can sometimes cause nerve damage (peripheral neuropathy), resulting in numbness or “pins and needles” sensations.
The abnormal proteins produced by myeloma cells can damage the kidneys. Kidney damage may not cause any symptoms at first, but it can be perceptible in a blood or urine test. Kidney damage may progress to kidney failure, when the kidneys can no longer filter fluid, salt, and waste from the blood. This can cause symptoms including weakness, shortness of breath, and swelling in the legs.
Patients with myeloma are much more prone to infections, and may be slow to respond to treatment. For example, pneumonia is very common in myeloma patients.
Last updated: Feb. 27, 2020
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