Description

Multiple myeloma (MM) is a cancer of plasma cells (a type of white blood cell) in the bone marrow. These malignant cells multiply uncontrollably, crowding out healthy blood cells and producing abnormal proteins (M proteins), leading to bone damage, kidney problems, and immune suppression. Key Features Bone destruction (lytic lesions, fractures). Kidney damage (due to excess M protein). Suppressed immunity (increased infection risk). Anemia (from crowded bone marrow). Causes & Risk Factors Age (most common in people >65). Monoclonal gammopathy of undetermined significance (MGUS) – Precursor condition. Family history of myeloma. Radiation/chemical exposure. Obesity, chronic inflammation. Symptoms (CRAB Criteria) Calcium elevation (hypercalcemia → confusion, thirst). Renal failure (kidney damage). Anemia (fatigue, weakness). Bone pain (spine, ribs, pelvis). Other symptoms: Frequent infections, weight loss, nerve damage. Treatment Options 1. First-Line Therapy Proteasome inhibitors (Bortezomib, Carfilzomib). Immunomodulatory drugs (Lenalidomide, Pomalidomide). Monoclonal antibodies (Daratumumab, Elotuzumab). Steroids (Dexamethasone). 2. Stem Cell Transplant Autologous (ASCT) – Standard for eligible patients. Allogeneic – Rare, high-risk option. 3. Maintenance Therapy Lenalidomide – Prolongs remission. 4. Advanced/Relapsed Myeloma CAR T-cell therapy (Ide-cel, Cilta-cel). Bispecific antibodies (Teclistamab). 5. Supportive Care Bisphosphonates (Zoledronic acid) – Prevent bone fractures. Erythropoietin – Treats anemia. Plasmapheresis – Reduces M protein in blood. Emerging Treatments Next-gen CAR-T therapies. Targeted radiotherapies. Vaccine-based immunotherapies.

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