Multiple Myeloma Treatment
Multiple myeloma is treated as part of the Hematologic
Malignancies Service at the University of Maryland Marlene and Stewart Greenebaum
Cancer Center. As a major academic medical center, we offer a comprehensive,
to treating multiple myeloma and other blood cancers, including a dedicated
Blood and Marrow Transplant Service.
Our Multidisciplinary Expertise
UMGCC takes a team approach to the treatment and care of patients with multiple
myeloma. Our treatment team includes physicians with special expertise in medical
oncology, hematology, blood and marrow transplantation, orthopedics, diagnostic
radiology, and cell component therapy as well as specialized nursing care and
support services for nutrition, pharmacy, dental care, social work, psychological
counseling, and palliative care.
Ashraf Badros is a nationally renowned expert in the treatment of multiple
myeloma and stem cell transplantation. His research
is focused on the development of new targeted drug therapies for multiple myeloma,
as well as innovative immulogical approaches to treatment of this disease. He
was involved in the initial scientific studies of the drug thalidomide and has
conducted many clinical
trials for the treatment of relapsed and refractory multiple myeloma. Dr.
Badros is a frequent speaker at regional and national multiple myeloma conferences
and patient education seminars.
(Read more about research highlights.)
About Multiple Myeloma
Each year, nearly 19,900 people in the United States will learn that they have
multiple myeloma, a cancer of the plasma cells. Plasma cells are
located in the bone marrow, the tissue in bones that makes blood. Plasma
cells are part of the immune system which help protect the body from
infections. They do this by producing antibodies -- proteins that fight foreign
substances that invade the body.
Usually, bone marrow contains only about two percent plasma cells. But when
a person has multiple myeloma, the body keeps making more and more abnormal
plasma cells, called myeloma cells, and they make more and more antibodies.
These extra cells do not help fight off infection. Instead, they stop the body
from making normal infection-fighting antibodies. These extra cells collect
in the bone marrow and slowly destroy the bone. Myeloma cells also trigger the
release of bone-weakening chemicals that lead to bone destruction and bone pain.
What are the symptoms of multiple myeloma?
The following are the most common symptoms of multiple myeloma; however, each
person may experience symptoms differently:
- bone pain in the back, ribs or other bones
- unexplained bone fractures
- excessive thirst and urination
- loss of appetite
How is multiple myeloma diagnosed?
Multiple myeloma may be found as part of routine blood or urine tests that
may show the presence of an abnormal myeloma protein called monoclonal (M) protein.
This protein is also sometimes called Bence Jones protein. Bone X-rays may
show holes in the bone called lytic lesions. After blood tests and X-rays, the
diagnosis is confirmed by testing the bone marrow during a bone marrow aspiration
and biopsy, to check on the presence of plasma cells.
After multiple myeloma is diagnosed, the doctor will need to know the extent
and characteristics of the myeloma cells to prescribe the best treatment. Chromosome
studies should be done on the bone marrow sample taken during the bone marrow
aspiration. Other important tests which help to evaluate patients include:
- b2 microglobulin
- C-reactive protein
- blood count
- calcium level
- kidney function
- type of abnormal myeloma protein
- comprehensive chemistry panel
- protein testing
- imaging studies, including MRI, PET/CT Scan, and bone marrow biopsy
- cardiac function tests
- pulmonary function tests
How is multiple myeloma treated?
People with stable or "smoldering" multiple myeloma may not need to be treated
at all initially. However, most people with multiple myeloma have symptoms and/or
extensive disease and need immediate treatment.
Multiple myeloma is treated in a variety of ways. Stem cell transplant is often
combined with chemotherapy. New drugs are continuously being developed and tested.
The specialists at UMGCC are involved in many of these clinical
How is stem cell transplantation used to fight
Stem cells are the "mother" cells in bone marrow. Stem cells
give rise to the formation of other blood cells, such as platelets (to prevent
bleeding), white cells (to fight infection) and red blood cells (to carry oxygen
throughout the body). In autologous ("auto" transplants), stem cells are actually
only a supportive care adjunct to the high doses of chemotherapy.
Chemotherapy is needed to fight multiple myeloma, but unfortunately chemotherapy
also hurts bone marrow function. During stem cell transplantation, stem cells
are taken from the patient's body, then frozen and stored. After high doses
of chemotherapy are given to kill the cancer cells, the stored stem cells are
given back to the patient through an intravenous line. The stem cells then migrate
back to the bone marrow where they begin producing healthy new blood cells.
In the meantime, higher than usual chemotherapy doses have been used to kill
Even though high-dose chemotherapy batters bone marrow function. But stem cell
transplantation allows patients who have undergone high-dose chemotherapy to
recover a normal blood cell count in as little as two weeks.
Stem cell transplantation has become much safer in recent years. The mortality
rate has dropped one to two percent, which is no higher than the mortality rate
for a six-month course of standard chemotherapy.
What can I do to cope with multiple myeloma?
Talk about your fears and worries with your doctor, nurse, other health professionals
and people with myeloma to help you deal with the stress of living with this
disease. UMGCC offers many supportive
services to help patients cope with their disease. The following suggestions
will help you fight multiple myeloma's symptoms:
- Stay active to help your bones be stronger.
- Talk to your doctor about medications and orthopaedic support devices if
pain keeps you from being active.
- Drink plenty of fluids to dilute monoclonal protein in your urine and prevent
- Eat a balanced diet to maintain your general health.
- Don't take medication or vitamins without getting approval from your doctor.
- Stool softeners should be used to prevent constipation if narcotic pain
medications are utilized.
- Bone strengthening medications are available
Who can I call with questions?
For more information about treatment for multiple myeloma, stem cell transplantation
or other programs for cancer treatment at UMGCC, please call 1-800-888-8823.
For new patient appointments or consultations, call the cancer center's New
Patient Referral Coordinator at 410-328-7904.
Other helpful organizations include the following:
For More Information:
Glossary of Terms
- anemia: a condition in which there is a low level
of oxygen-carrying hemoglobin in the blood. Hemoglobin is carried by red
- b2 microglobulin: a type of protein in plasma.
- Bence Jones protein: a portion of the abnormal
myeloma protein referred to as the "light chains."
- bone marrow: the spongy tissue found inside bones that makes stem
cells, which grow and divide to become red blood cells, white blood cells
- C-reactive protein: an abnormal protein in the
blood that is seen in myeloma patients
- chemotherapy: oral or I.V. drugs which attack cancer cells and
may have powerful side effects.
- chromosome studies: tests on bone marrow to see
if the plasma cells in myeloma have abnormal genes. Certain abnormalities
are associated with a poor prognosis
- immune system: the body's defense system against disease, infections
and other foreign organisms.
- lytic lesion: holes in the bones caused by myeloma
cells that are visible by X-ray.
- monoclonal (M) protein: the protein made by myeloma cells.
- multiple myeloma: a cancer of the plasma cells
that are in the bone marrow.
- plasma cell: a type of white blood cell that helps protect against
- platelets: blood cells that clot the blood.
- red blood cells: blood cells that carry oxygen to all parts of
- stable or "smoldering" multiple myeloma: myeloma
that is not growing or progressing.
- stem cells: the mother cells of blood, made by bone marrow, that
develop into white blood cells, red blood cells and platelets
- white blood cells: blood cells that defend against
infection (also called leukocytes and granulocytes).