Risk Factors and Diagnosis of Multiple Myeloma

Multiple myeloma is a type of blood cancer, and is related to leukemia and lymphoma. It occurs when plasma cells, a type of white blood cell, release excess immunoglobulin in the blood and bones. This causes build-up and eventual organ and tissue damage. Moreover, the plasma cells crowding the normal ones creates weakness in bones, which spreads throughout the body, causing organ damage.

There are a variety of possible risk factors that could contribute to the diagnosis of multiple myeloma, including the following:

1. Risk factors for multiple myeloma

  • Family history
    Having a family member who has had multiple myeloma could increase the possibility of one developing the disease by four times as compared to others who have no such family history.
  • Obesity
    According to research, people who are obese are more prone to developing multiple myeloma.
  • Age
    When it comes to being diagnosed with multiple myeloma, the majority of the people are more than 65 years of age. It has been observed that when it comes to young adults, a very small chunk is diagnosed with multiple myeloma.
  • Gender
    When it comes to multiple myeloma, women are at lower risk of developing the disease as compared to men.
  • Race
    For reasons that are yet unknown, the occurrence of multiple myeloma is two times higher in African-Americans as compared to Caucasians.

Other conditions such as a personal history of MGUS (monoclonal gammopathy of undetermined significance) and those exposed to radiation could be risk factors of multiple myeloma.

2. Diagnosing multiple myeloma
There are routine urine tests, blood tests, and physical exams which can uncover evidence of multiple myeloma. Additional tests will be required if the signs of myeloma are vague.

  • Blood and urine tests
    These are used to check for M proteins, which could be caused by multiple myeloma or other conditions as well. Blood tests can also be employed to understand:

    • Uric acid levels
    • Calcium levels
    • Blood cell counts
    • Kidney function
    • Percentage of plasma cells in the bone marrow
  • Imaging tests
    CT scans, MRI scans, or X-rays can be employed to find out whether the bones have been damaged by multiple myeloma.
  • Biopsy
    During a biopsy, the doctor removes a small bone marrow sample with a long needle. This is then tested for cancerous cells. Multiple different tests can be used to determine the kinds of abnormalities in the cells and how quickly they are multiplying. Most tests are employed to determine if one has multiple myeloma or another condition. If the former is found, the tests also demonstrate how far it has progressed, a process known as staging.
  • Staging
    Multiple myeloma can be staged by looking at:

    • Calcium levels in the blood
    • Protein levels in blood and urine
    • Blood cell counts

International Staging System (ISS) and the Durie-Salmon system are used to understand the progress of the condition based on beta-2 microglobulin and blood plasma levels and the levels of red blood cells, calcium, M protein, and the degree of bone damage, respectively.