Plasma cells, a type of white blood cell found in the bone marrow, help your body fight infection by producing proteins called antibodies. When plasma cells become cancerous and grow out of control, they overcrowd healthy cells and harm the body. This is called multiple myeloma.
Hans Lee, M.D., recently spoke with us about multiple myeloma diagnosis and treatment, as well as new therapies on the horizon.
Here’s what he had to say.
How is multiple myeloma diagnosed?
The most common way to diagnose myeloma before symptoms appear is through routine blood work. If a patient has elevated protein levels, several tests are conducted, and their combined results are interpreted to make a myeloma diagnosis.
What are common multiple myeloma symptoms?
Multiple myeloma patients often have problems with anemia, so they’ll be pale and fatigued. Myeloma can also affect the bones, breaking them down and causing pain. The body overcompensates to repair the damaged bones, so a patient may have high calcium levels. Finally, myeloma can cause kidney problems due to overproduction of proteins that deposit in the kidneys by the myeloma cells.
Are some people more likely to develop multiple myeloma?
As people get older -- above age 65 -- their chances of developing multiple myeloma go up.
Multiple myeloma is slightly more common in African-Americans, as well as in men.
Also, those who’ve had prior radiation exposure are more likely to be diagnosed with myeloma, and Agent Orange exposure may also put a person at increased risk.
How is multiple myeloma treated?
There’s no cure for multiple myeloma. But, we can manage the disease -- for decades, in some cases -- to enable patients to lead normal lives.
We tailor each treatment plan to a patient’s situation. We evaluate symptoms and how far the disease has advanced.
In some cases of myeloma where there are no symptoms, known as smoldering myeloma, we don’t treat the patients at all. We simply monitor them closely.
In myeloma patients who show symptoms, initial treatment involves a combination of drugs that are typically very effective. We also offer high-dose chemotherapy to kill the defective plasma cells and then stem cell transplantation to revitalize the bone marrow so it can start producing healthy cells. A stem cell transplant can be a viable way to recover a patient’s bone marrow and return the stem cells to proper function. MD Anderson’s expertise and resources enable us to offer these life-saving procedures to more patients who were previously considered at high risk for complications.
How is MD Anderson’s High-Risk Multiple Myeloma Moon Shot advancing care?
There are two conditions that can be precursors to multiple myeloma: monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. Earlier intervention in patients with these conditions means better prognosis and patient outcomes.
Our goal with the High-Risk Myeloma Moon Shot™ is to better understand these warning signs and prevent development to full-blown disease. We’re doing this by studying the cancer’s molecular makeup and by exploring new therapies to stimulate the immune system to fight the disease through ongoing clinical trials. For example, one clinical trial is investigating the use of an immune cell called natural killer cells for myeloma when administered at the same time as a stem cell transplant.
What new myeloma therapies are on the horizon?
One exciting area in myeloma research is immunotherapy. In 2015, two new drugs were approved by the FDA for myeloma; they’re called daratumumab and elotuzumab. Both drugs act by binding to specific proteins on the surface of the myeloma cells and stimulate the immune system to kill the myeloma cells. Now we’re testing a number of other drugs that target myeloma cells or the immune system using similar mechanisms.
We’re also exploring the use of CAR-T cells, which are specially programmed immune cells that attack myeloma cells. Finally, we’re continuing to discover what causes myeloma cells to grow or become resistant to standard treatments, and finding new drugs to overcome these hurdles.
There’s a lot of optimism and hope for myeloma patients as these new therapies will undoubtedly continue to build on the significant improvements in outcomes over the last decade.