Each year, 2.3 million Americans develop multiple myeloma. This represents 2% of the United States’ population. The prevalence is 0.37% for men, and 0.58% for women.
MM manifests clinically as bone and/or joint pain, anemia, elevated serum IgG levels, low levels of bone marrow cellularity, and often, elevated calcium levels. The clinical course of MM is variable, ranging from a chronic illness (i.e., the presence of only one or a few of these features) to a malignant disease with significant, immediate, short-term toxicity, high-dose chemotherapy, myeloablative therapies, or bone marrow transplantation. Treatment for MM involves both the use of autologous stem cell transplantation and novel agents like thalidomide. A specific definition of MM in the context of immunohematologic disorders does not exist.
This case study demonstrates that MMI and CMI are not universally positive in every patient; careful consideration is needed before concluding an MMI or CMI for a patient with M/M.
The most common treatment for myeloma is chemotherapy. Other common treatments include physical therapy, pain medications, and splenectomy, and stem cell therapies (SCT). There is no proven effective treatment for multiple myeloma that has been tested in placebo-controlled trials. For most patients, a combination of these treatments provides the best outcomes.\nprosthesis-related complications question: What are common treatments for arthroplasty related problems? answer: While no single cause of revision exists, poor clinical outcomes and increased risk of implant infection are associated with revision. The most common cause of revision is aseptic loosening-related revision; however, infection is also a major cause of device failure.
Drugs have a major impact, as does trauma. Other factors (including genetics, lifestyle and exposure to infection) have an impact. A number of hypotheses are also suggested.
MM can be cured with a good response, but relapse must occur frequently. Relapse is often refractory to BSA+3 drugs. Future clinical trials should evaluate BH3M protein expression as a molecular biomarker to predict and prevent relapse in MM.
Patients with multiple myeloma who received multiple treatments (including chemotherapy, radiotherapy, and bisphosphonate) show less improvement in quality of life during early treatment, which suggests the need for more treatment strategies.
People with multiple myeloma are at high risk for developing life-threatening complications, such as infection, sepsis and severe anemia, and the risks from treatment are very real. However, given that almost 90% of people with multiple myeloma survive 5 years after diagnosis, these life-threatening risks are not frequent enough to make treatment unsafe. There are even some advantages to treatment. For example, treatment-initiated people have a normal life expectancy. The longer people live, the better.
Most patients reported mild to moderate side effects. The patients in our study were treated with very low doses of bortezomib and lenalidomide that did not cause toxicity detectable by laboratory parameters, and in which only few patients reported severe side effects (nausea, diarrhoeas). We believe these side effects were manageable and should not cause concern, even if serious in case of prolonged treatment with bortezomib. Our patients showed a great interest in receiving treatment for multiple myeloma or myelodysplastic syndromes as in general oncology wards. However, this did not appear to be a reason to refuse treatment to patients.
The current study has demonstrated that there is a definite lower chance of developing myeloma if the diagnosis of multiple myeloma is delayed. A delay from a period of time from diagnosis of multiple myeloma to commencement of treatment is likely to affect the clinical outcome of the disease.
Although the efficacy results have been consistent, the majority of clinical trials have been too limited and small to be applicable to clinical practice. The high levels of heterogeneity among studies (interaction effect, statistical heterogeneity) preclude a straightforward conclusion to be reached from meta-analysis. There appears to be at least an initial difference in the mean survival rates for myeloma patients treated with alkylating agents (i.e. melphalan) compared to those treated with a control, and the results appear to be reliable.
Almost all patients with MM (97%) had low-grade tumor-burden disease at diagnosis and only 4% developed BMF. In contrast, MM patients tended to be older and have a worse PFS and OS. In a recent study, findings indicate that MM patients with no BMF should qualify for a watchful-waiting policy and that MM patients with BMF present more rapidly proliferative high-risk myeloma.