As the disease progresses, some of the following symptoms can occur:
- Bone disease: Tiny fractures in the bones from too many plasma cells and bone-dissolving cells called osteoclasts are common in people with MM. Bones may become weak and prone to breaking. Patients often feel pain in the lower back, pelvis, ribs, and skull.
- Spinal cord compression, which causes nerve damage, is one of the most severe effects of myeloma.
- Bone lesions: About 70% of MM patients have disease-related bone lesions. Magnetic resonance imaging (MRI) and PET/CT scans can determine whether or not bone tumors or lesions exist and where they are located in the body.
- Treatment: To manage skeletal symptoms, patients usually need to take calcium supplements and bone-strengthening medications such as pamidronate (Aredia) or zoledronic acid (Zometa). Patients must avoid straining the spine by not carrying heavy weight. Some patients may need injections of a cement-like substance called vertebroplasty or kyphoplasty into the spine. This helps prevent further collapse of the spine.
- Hypercalcemia: When bones are damaged, excess calcium can build up in the blood, causing a condition called hypercalcemia. This condition needs urgent treatment. Raised calcium levels can take a toll on the kidneys and cause fatigue, muscle weakness, loss of appetite, nausea, and confusion.
- Kidney damage: If left untreated, excess too much myeloma protein can cause kidney damage or even renal (kidney) failure. Patients may need a kidney biopsy to find the exact cause of the kidney damage.
- Treatment: To manage kidney problems, patients must stay hydrated. Patients must avoid non-steroidal anti-inflammatory drugs (such as aspirin and ibuprofen) and intravenous contrast agents.
- Anemia: In MM patients, the growth of red blood cells—which carry oxygen throughout the body—often slows down. This can cause anemia. Anemia causes extreme tiredness, weakness, and dizziness. It can also cause shortness of breath. Most MM patients develop anemia.
- To manage anemia, patients should receive drugs that stimulate the growth of red blood cells, such as Procrit or Aranesp. Some patients may also need to get blood transfusions.
- Infections: MM patients have reduced white blood cell counts, meaning their bodies are less likely to produce the lymphocytes and antibodies necessary to fight infection. That means patients are much more likely to get infections such as pneumonia, urinary tract infections, and shingles. Chemotherapy can lower white blood cell counts even more, putting a patient at even greater risk.
- Patients will often get antibiotics to manage infections. If infections keep coming back and are life-threatening, the patient may need to receive antibodies injected in the vein.
- Nervous system complications: Collapsing bone structures can press on nerves, causing severe pain, numbness, tingling, and muscle weakness. Amyloidosis, a rare complication of myeloma, can cause a condition called polyneuropathy. Polyneuropathy occurs when peripheral nerves throughout the body stop functioning at the same time. It typically starts in the feet. Medications such as Thalidomide, Velcade, and Vincristine can also cause polyneuropathy.
- Thickening of the blood: The abnormal proteins myeloma cells make can cause a dangerous thickening of the blood called hyperviscosity. When blood cannot flow properly and becomes thick and sticky, the result can be bruising, nose bleeding, gastrointestinal bleeding, hazy vision, confusion, numbness in the limbs, chest pain, and shortness of breath. Patients may need a procedure called plasmapheresis, which replaces thick blood with other fluids.
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