CONSUMER BACKGROUNDER                                                                                                                       

About multiple myeloma

 

About multiple myeloma

  • Multiple myeloma is a cancer that develops from abnormal plasma cells. A plasma cell is a type of white blood cell found in the bone marrow, that forms part of the immune system and helps to protect against infection.1, 2

  • The abnormal plasma cells crowd the bone marrow and make it difficult to produce enough normal blood cells.2

 

Prevalence

  • Multiple myeloma is the third most common type of blood cancer, after lymphoma and leukaemia, and is in the top 18 most common cancers in Australia.2, 3

  • Multiple myeloma can affect people of any age, although the average age at diagnosis is approximately 70 years.4

  • Multiple myeloma is also more common in men than women.4

  • In 2019 alone it is estimated that 2,000 Australians will be diagnosed with multiple myeloma, and approximately 1,062 will die from this form of blood cancer.

  • Approximately 18,000 people in Australia are living with myeloma at any one time.6

  • Multiple myeloma has a 51% survival rate five years post diagnosis.5

  • Multiple myeloma accounts for about 10% of all blood malignancies.7

 

Causes

  • The exact cause of multiple myeloma is unknown, however there has been progresss in understanding how certain gene changes in DNA can make plasma cells become cancerous.8, 9

  • Although there are no obvious strong risk factors of multiple myeloma, there are some factors, both environmental and genetic, which may put individuals at a higher risk of developing myeloma.10

  • Certain chemicals, viruses (such as HIV) and radiation have been linked to increased risk of multiple myeloma.2

 

Symptoms

  • Multiple myeloma can be challenging to diagnose because of the wide range of symptoms the disease can present with, including hypercalcemia (high blood calcium levels), anaemia, kidney failure, recurrent infections and bone pain.11

  • Anaemia presents in approximately 70% of cases of those with newly diagnosed myeloma.11

  • Kidney failure occurs in 20-40% of newly diagnosed patients with myeloma.11

  • Bone pain, in particular back pain, is also a fairly common symptom occurring in up to 58% of patients.11

  • Hypercalcemia  is a less common manifestation of multiple myeloma, presenting in approximately 13% of newly diagnosed patients.11

 

Diagnosis of multiple myeloma

  • Multiple myeloma is routinely diagnosed using blood tests, urine tests, a bone marrow biopsy, x-rays, and other more specialised bone imaging tests.12

  • A full blood count is used to measure the number of red cells, white cells and platelets in circulation, as well as their size and shape, which can be used to determine whether normal blood cells are being affected by myeloma.2, 12, 13

  • Bone marrow examination involves removing a small sample of bone marrow for assessment, to determine the number and type of cells present.2, 12, 13

  • Bone x-rays and scans (CT and MRI) can be used to assess bone health, osteoporosis, osteolytic lesions and evidence of multiple myeloma in bones.2, 13

 

Psychological Impact

  • The fear of relapse or relapse itself can carry a high emotional burden to patients, an issue which is not as widely addressed as the clinical challenges and economic costs associated with the disease.14

  • Studies have shown that approximately 40% of myeloma patients experience symptoms of anxiety and depression.15 This can be attributed to a multitude of factors including increased dependency and relying on others to perform daily tasks, fear and uncertainty about the future as myeloma still remains ‘incurable’, as well as increased pain and fatigue.15

  • Improving the impact of treatment and extending the time in remission may play a role in psychological wellbeing.14

 

Treatment of multiple myeloma

  • Myeloma treatment is dependent on several factors including the stage of cancer, the person’s general health, age, prior treatments, response to previous treatment and any associated complications.16

  • Current therapy for multiple myeloma includes a phased-approach, often consisting of initial induction therapy, consolidation and maintenance therapy.17

  • Treatment options for multiple myeloma include; chemotherapy, radiation therapy, cortico-steroids, autologous stem cell transplant (ASCT), immunomodulating drugs (IMiDs) and proteasome inhibitors.16

  • Chemotherapy is one the main forms of treatment used to control, damage and kill cancer cells. Most cancer cells are more vulnerable to the effects of chemotherapy than normal cells, but some normal cells are also damaged.16

  • Radiation therapy is a local therapy that uses high energy x-rays to kill cancer cells and shrink tumours.16

  • There has been a great deal of research in myeloma over the last 10 years and the addition of immunomodulatory treatments and proteasome inhibitor therapies has improved the outcomes for people being treated with myeloma.16

  • Immunomodulatory treatments act to boost the immune system, have anti-inflammatory properties, reduce the production of new blood vessels, and minimise the ability of the myeloma cells to multiply.16, 18

  • Proteasome inhibitors are targeted therapies that work by blocking the action of the “waste disposal unit” for cells, responsible for breaking down and recycling proteins from old cells. Proteasome inhibitors block the waste disposal unit in myeloma cells, limiting their growth and survival.16

  • An autologous stem cell transplant is used to replace stem cells that have been damaged by high doses of chemotherapy. It involves the collection of stem cells from the person’s own bone marrow when they are in remission or their disease is in a more stable state.19

 

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For more information, please contact Julia Slater from VIVA! Communications on +61 422 074 354 or julia@vivacommunications.com.au

NP-AU-NA-0030

 

References

1.  Prince, H.M. Combination therapies for front-line treatment in myeloma – the wait for Australian patients is finally over [in press]. 2020.

2.  Cancer Council. Myeloma.  [cited March 2020]; Available from: https://www.cancer.org.au/about-cancer/types-of-cancer/myeloma.html.

3.  Australian Institute of Health and Welfare. Cancer data in Australia. 2019  [cited March 2020]; Available from: https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/rankings?request=smoothstate.

4.  Leukemia Foundation. What is myeloma? .  [cited Sept 2019]; Available from: https://www.leukaemia.org.au/disease-information/myeloma/.

5.  Australian Government Cancer Australia. Myeloma in Australia statistics. 2019  [cited March 2020]; Available from: https://myeloma-cancer.canceraustralia.gov.au/statistics.

6.  Myeloma Australia. What is myeloma.  [cited March 2020]; Available from: https://myeloma.org.au/what-is-myeloma/.

7.  Joshua, D.E., et al., Biology and therapy of multiple myeloma. Med J Aust, 2019. 210(8): p. 375-380.

8.  National Organization for Rare Diseases. Multiple Myeloma.  [cited Sept 2019]; Available from: https://rarediseases.org/rare-diseases/multiple-myeloma/.

9.  American Cancer Society. What Causes Multiple Myeloma?  [cited December 2019]; Available from: https://www.cancer.org/cancer/multiple-myeloma/causes-risks-prevention/what-causes.html.

10.  Cancer.Net. Multiple Myeloma: Risk Factors and Prevention. 2018  [cited December 2019]; Available from: https://www.cancer.net/cancer-types/multiple-myeloma/risk-factors-and-prevention.

11.  Eslick, R. and D. Talaulikar, Multiple myeloma: from diagnosis to treatment. Aust Fam Physician, 2013. 42(10): p. 684-8.

12.  Leukemia Foundation. Myeloma diagnosis.  [cited Sept 2019 ]; Available from: https://www.leukaemia.org.au/disease-information/myeloma/how-is-it-diagnosed/.

13.  Cancer Council Victoria. Multiple myeloma.  [cited March 2020]; Available from: https://www.cancervic.org.au/cancer-information/types-of-cancer/multiple_myeloma/multiple-myeloma-overview.html.

14.  Hulin, C., et al., Living with the burden of relapse in multiple myeloma from the patient and physician perspective. Leuk Res, 2017. 59: p. 75-84.

15.  Molassiotis, A., et al., Living with multiple myeloma: experiences of patients and their informal caregivers. Support Care Cancer, 2011. 19(1): p. 101-11.

16.  Leukemia Foundation. Myeloma Treatment.  [cited March 2020]; Available from: https://www.leukaemia.org.au/disease-information/myeloma/how-is-it-treated/.

17.  Lipe, B., R. Vukas, and J. Mikhael, The role of maintenance therapy in multiple myeloma. Blood cancer journal, 2016. 6(10): p. e485-e485.

18.  Holstein, S.A. and P.L. McCarthy, Immunomodulatory Drugs in Multiple Myeloma: Mechanisms of Action and Clinical Experience. Drugs, 2017. 77(5): p. 505-520.

19.  Leukemia Foundation. Autologous stem cell transplants.  [cited Oct, 2019]; Available from: https://www.leukaemia.org.au/disease-information/transplants/autologous-transplants/.

Media contacts
Julia Slater 
0422 074 354/  (02) 9968 3741
VIVA! Communications
Buildings 5 & 6, 1110 Middle Head Rd
Mosman, NSW, 2088