This page was reviewed under our medical and editorial policy by Maurie Markman, MD, President, Medicine & Science
This page was updated on July 20, 2022.
Although it only accounts for about 1 percent of overall cancers, multiple myeloma is the third most prevalent blood cancer after non-Hodgkin lymphoma and leukemia. According to the American Cancer Society, about 35,780 new cases of multiple myeloma will be diagnosed in 2024—19,520 in men and 16,260 in women.
At City of Hope, our multidisciplinary cancer care team of medical oncologists, hematologists and supportive care clinicians work together to diagnose the disease in an efficient, timely manner and explain the treatment options available to you, so you can make informed decisions about your care. Various treatments are used for multiple myeloma. Which is appropriate for you generally depends on the symptoms you are experiencing, among other factors. Patients with early-stage multiple myeloma with no symptoms, for example, may be closely monitored by their doctor, through an approached called active surveillance. Those with symptoms may be treated with chemotherapy or targeted therapy, and sometimes, stem cell transplantation. Other treatments, such as radiation therapy, interventional radiology and surgery, may also be recommended in certain circumstances.
This overview will cover the basic facts about multiple myeloma, including:
If you believe you may be experiencing symptoms of multiple myeloma and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for your multiple myeloma diagnosis and treatment plan, call us or chat online with a member of our team.
Multiple myeloma is a blood cancer also known as bone marrow cancer because it develops in plasma cells in bone marrow. Plasma cells develop from B cell lymphocytes, a type of white blood cell. Plasma cells help the body’s immune system fight disease by producing antibody proteins in response to bacterial infections or viruses.
When cancer grows in these cells, it causes an excess of abnormal plasma cells, which form tumors in multiple locations throughout the bone marrow and crowd out and prevent the production of normal blood cells. This often leads to low blood counts, impairing the body’s ability to fight off infection.
When malignant plasma cells (cancerous cells called myeloma cells) collect in only one bone and form a single mass or tumor, it is called a solitary plasmacytoma. In most cases, however, the myeloma cells grow out of control and collect in many bones, often forming many tumors. When this happens, the disease is called multiple myeloma, also known as plasma cell myeloma. This type of cancer generally doesn’t produce symptoms until it has advanced, so it typically isn’t diagnosed until it has spread.
While cancer research has not determined the exact cause of multiple myeloma, several factors may increase the risk of plasma cell neoplasm diseases.
The risk factors for multiple myeloma include:
The incidence of multiple myeloma is twice as high in African Americans as in whites. Men are at a slightly increased risk of developing the disease compared to women.
Only a very small percentage of young adults are diagnosed with multiple myeloma, so young people are not considered a high-risk group. The majority of those diagnosed are over 65 years old. The average age at diagnosis is 69, according to the National Cancer Institute (NCI).
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Multiple myeloma has many types, each based on the type of immunoglobulin (protein) produced by the abnormal plasma cells.
Although multiple myeloma affects the bones, it begins with abnormalities in the cells of the bone marrow. Therefore, multiple myeloma is different from bone cancer, in which cancer cells form in the hard, outer part of the bone.
Light chain amyloidosis is the term for a form of malignant plasma cell disorder that causes a smaller number of abnormal plasma cells in the bone marrow than multiple myeloma.
Smoldering multiple myeloma, also called asymptomatic myeloma, is a slow-growing form of the disease characterized by increased plasma cells in the bone marrow and the presence of monoclonal proteins, without the presence of symptoms.
Multiple myeloma is also divided into two categories:
The early stages of multiple myeloma often display no symptoms. Symptoms typically don’t appear in multiple myeloma patients until the disease reaches an advanced stage. In some cases, the disease is discovered during a routine blood test or a test to diagnose another condition.
Multiple myeloma symptoms vary for each person. Common symptoms include:
In addition to symptoms, multiple myeloma patients may develop one or more of the following conditions:
Multiple myeloma is often difficult to diagnose and may require several different tests to analyze. Tests for diagnosing multiple myeloma include:
Multiple myeloma treatment generally depends on the stage of the cancer, whether you are a candidate for a stem cell transplant, and other factors, such as personal preferences and needs. Treatment options for multiple myeloma may include:
Once you're treated for multiple myeloma, your care team will continue to monitor you so they'll know right away if your myeloma has relapsed and can evaluate whether you need additional treatments.
At City of Hope, we know that treatment depends on many factors, including the disease progression and the patient’s individual needs and goals. Your care team will work with you to design a comprehensive, personalized multiple myeloma treatment plan, which may include supportive care services designed to help manage disease- or treatment-related side effects.
Multiple myeloma patients may experience side effects, including anemia, aches and pains in the neck and back, headaches, difficulty walking, fatigue and peripheral neuropathy. The disease also may cause bone pain and unexplained fractures.
One therapy your care team may recommend to help with side effects is kyphoplasty, a minimally invasive procedure used to relieve pain from compression fractures of the spinal vertebrae caused by multiple myeloma. Supportive care services, including those below, also may be helpful.
Supportive care therapies that may be recommended to help patients with multiple myeloma stay strong and maintain their quality of life include:
