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Multiple Myeloma Symptoms and Diagnosis

Symptoms

Diagnosis

Staging

Multiple Myeloma Symptoms:
The following symptoms may be caused by multiple myeloma or other conditions. A doctor should be consulted if any of the following problems occur:

  • Bone pain, often in the back or ribs.
  • Bones that break easily.
  • Fever for no known reason or frequent infections.
  • Easy bruising or bleeding.
  • Trouble breathing.
  • Weakness of the arms or legs.
  • Feeling very tired.

A tumor can damage the bone and cause hypercalcemia (a condition in which there is too much calcium in the blood). This can affect many organs in the body, including the kidneys, nerves, heart, muscles, and digestive tract, and cause serious health problems.

Hypercalcemia may cause the following symptoms:

  • Loss of appetite.
  • Nausea or vomiting.
  • Feeling thirsty.
  • Frequent urination.
  • Constipation.
  • Feeling very tired.
  • Muscle weakness.
  • Restlessness.
  • Mental confusion or trouble thinking.

In rare cases, multiple myeloma can cause organs to fail. This may be caused by a condition called amyloidosis. Antibody proteins build up and may bind together and collect in organs, such as the kidney and heart. This can cause the organs to become stiff and unable to function.


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Diagnosis For Multiple Myeloma Patients:
The diagnosis of multiple myeloma is often made incidentally during routine blood tests for other conditions. For example, the existence of anemia and a high serum protein may suggest further testing. A diagnosis of multiple myeloma is difficult to make on the basis of any single laboratory test result. Accurate diagnosis generally results from consideration of a number of factors, including physical evaluation, patient history, symptoms, and lab results.

A number of laboratory tests and medical procedures are used to help confirm a diagnosis of myeloma. These tests should be conducted on all patients as part of an initial evaluation. It is very important for patients to undergo all appropriate tests, as these tests help physicians determine treatment options. Many of these tests are also used to assess the extent of disease and to plan and monitor treatment.

Standards for diagnosis currently require confirmation of 1 major and one minor criterion or 3 minor criteria in a patient displaying symptoms of myeloma.

Major criteria:

  • A biopsy-proven plasmacytoma.
  • A bone marrow sample showing 30% plasma cells.
  • Elevated monoclonal immunoglobulin levels in the blood or urine

Minor criteria:

  • A bone marrow sample showing 10%-30% plasma cells.
  • Minor monoclonal immunoglobulin levels in blood or urine
  • Imaging studies revealing holes in bones due to tumor growth
  • Antibody levels (not produced by the cancer cells) in the blood are abnormally low

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Staging:
Patients with myeloma can be classified as having either inactive disease or active disease.
Inactive disease is asymptomatic disease that does not require immediate treatment. Patients with inactive disease do not have evidence of any myeloma-related organ or tissue impairment (also known as end-organ damage). Inactive disease includes the following classifications subtypes of myeloma:

  • Monoclonal gammopathy of undetermined significance (MGUS)
  • Smoldering myeloma (SMM)
  • Indolent myeloma (IMM)
  • Stage I disease

Active disease is symptomatic disease that requires treatment. Patients with Stage II and Stage III disease fall into this category.


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