Multiple myeloma

Around 370* people are diagnosed with myeloma each year in Ireland. It usually affects people over 50 years of age.

Detecting cancer early

Signs and symptoms

Learn about the signs and symptoms of multiple myeloma. You are more likely to survive cancer if you find it at an earlier stage. 

Treatments

Treatments

There are a number of different treatments available for multiple myeloma. Your medical team will explain the best treatment options for you. 

What is multiple myeloma?

Multiple myeloma (also called myeloma) is a cancer of the plasma cells, which are a type of white blood cell made in the bone marrow. About 370 people are diagnosed with myeloma in Ireland every year.* There are several treatments that can slow down and control multiple myeloma very well. 

When you have myeloma, abnormal plasma cells are made in your bone marrow. These abnormal cells are called myeloma cells. 

  • Healthy plasma cells. Produce antibodies (immunoglobulins) to fight infection and keep you healthy. 
  • Abnormal plasma cells (myeloma cells). Usually produce a lot of abnormal antibodies called paraproteins (or M proteins). Paraproteins can reduce the amount of normal antibodies being made. This affects your ability to fight infection and build immunity, which can result in more infections. 
  • The myeloma cells build up in the bone marrow, leaving less room for normal plasma cells to develop. This may cause complications and symptoms, such as bone pain, fractures, infections, reduced kidney function and reduced numbers of red and white blood cells.

Why is it called multiple myeloma?

Myeloma cells can move from the soft bone marrow into the harder part of bone and cause damage to bone tissue. 

The disease affects multiple places in the body where the bone marrow is normally active – this is why it is called ‘multiple’ myeloma.

Understanding multiple myeloma

Multiple myeloma can be a difficult disease to understand. Always ask your doctor or nurse if you don't understand something. It's important to remember the following:

Multiple myeloma is described as a complex disease because build-up of myeloma cells can affect many areas of your body.

Multiple myeloma is treated as a chronic (long-term) illness. With new drug treatments, patients are living much longer and leading fuller lives. Current treatments can bring about a complete remission in some patients. This means that the symptoms of multiple myeloma disappear and the bone marrow recovers, but this does not mean that the disease is cured.

Multiple myeloma is an individual disease: it can affect different people in very different ways. For example, one patient can have bone disease and another patient might have problems with their kidneys. 

Your treatment will be tailored to you. Both you and your doctor will decide what treatment is the best way to manage your disease, so ask questions, get the necessary information and consider your treatment options.

What are the types of myeloma?

How multiple myeloma might affect you and how effective treatment is can depend on many things, including the type of myeloma you have.

Understanding immunoglobulins

What is an immunoglobulin? 

Immunoglobulin is another word for antibody. Antibodies are proteins that protect your body from infection and disease. Your body produces 5 main types of immunoglobulins to help you to fight infection. Each type of immunoglobulin has a different function in fighting disease. 

Light chains and heavy chains 

Immunoglobulins (antibodies) are made up of 2 types of proteins – light chains and heavy chains. 

  • Heavy chains: Each immunoglobulin is identified by a letter – A, D, E, G or M. These letters refer to the type of heavy chains in the immunoglobulins. The 5 types of immunoglobulin are often described as IgA, IgD, IgE, IgG and IgM. 
  • Light chain: The immunoglobulins also have 2 light chain portions, which are called kappa (K) or lambda (L). 

Abnormal immunoglobulins and myeloma 

With myeloma you produce an abnormal type of immunoglobulin. There are different types of myeloma, depending on the type of abnormal immunoglobulin (Ig) made by the myeloma cell. The most common ones are IgG and IgA. The others are quite rare.

Types of myelomas

The myeloma cells do not produce a whole immunoglobulin (paraprotein) and only produce light chains. The light chains can block the tiny tubes of the kidneys and cause inflammation and damage to the kidney tissue. Patients with this type of myeloma have an increased risk of kidney impairment/reduced kidney function.

Plasma cells collect and form a tumour in a single bone of the skeleton, ribs, vertebrae, skull, sternum or pelvis. People with solitary plasmacytoma do not have myeloma cells elsewhere in their body and do not have the complications or symptoms of blood, infections, high calcium or renal (kidney) impairment. You may have radiation, surgery, or both to treat a solitary plasmacytoma. You will be monitored with blood tests in case you go on to develop multiple myeloma at a later stage.

An extremely rare type of myeloma. No paraproteins are detected in the blood or urine. It may be more difficult to diagnose and monitor.

EMM is where the myeloma plasma cells are found outside the bone marrow. This can present as a soft tissue collection of myeloma cells or infiltration of a site outside the bone marrow, most commonly the liver, skin or lymph nodes.

A very rare and aggressive subtype of multiple myeloma where lots of abnormal plasma cells are found in the blood. Patients can be diagnosed with this disease at presentation or more usually when multiple myeloma progresses to a more advanced stage. Patients with plasma cell leukaemia require more intensive treatment and monitoring.

For more information about your subtype, talk to your doctor or nurse.

What increases my risk of multiple myeloma?

The cause of multiple myeloma is unknown. But there are certain things called risk factors that can increase your chance of developing the disease. These include:          

  • Age: Multiple myeloma happens mostly in people aged over 50.
  • Gender: It is more common in men than women.
  • Race: It is more common in black people than in white or Asian people.
  • Exposure to gases and chemicals: Lifelong exposure to chemicals can affect your immune system and increase your risk. These include petrol, oil, benzene, certain pesticides, dioxins, paints, rubber and hair dyes. 
  • Plasma cell conditions: People with monoclonal gammopathy of uncertain significance (MGUS) or smouldering myeloma or amyloidosis have a much higher risk of myeloma.  
  • Other medical conditions: These include autoimmune illnesses, pernicious anaemia, ankylosing spondylitis and other illnesses that affect your immune system.
  • Exposure to viruses: These include HIV, hepatitis, herpes virus 8 and simian virus 40.
  • Exposure to radiation: This includes exposure to high doses of radiation in industry or nuclear accidents or to previous radiotherapy.
  • Family history: If your parent, brother or sister had multiple myeloma your risk is increased but the risk is low. 

Having a risk factor doesn’t mean you will get cancer. Sometimes people with no risk factors get the disease. 

Medical content updated from our 'Understanding multiple myeloma' booklet (2024), reviewed by John Quinn, Consultant Haematologist, Geraldine Walpole, Advanced Nurse Practitioner in Haematology and Aileen Emery, Daffodil Centre Nurse.


Continue reading about multiple myeloma

Read next Multiple myeloma signs and symptoms

Publications about multiple myeloma

Multiple myeloma
Multiple myeloma
Booklet 73 pages 8.85 MB
Information for myeloma patients, including tests, staging, treatment and side-effects, and how to cope.

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*The Irish Cancer Society uses the most up-to-date cancer statistics from the National Cancer Registry Ireland, available on www.ncri.ie