×

Multiple Myeloma - Stages and Types of Multiple Myeloma

Home> Multiple Myeloma> Overview and Types

What Is Multiple Myeloma?

Multiple myeloma, or multiple myeloma cancer, is a rare and complex form of blood cancer that originates in plasma cells, a form of immune cell that is responsible for the production of antibodies. These cancerous plasma cells undergo uncontrolled growth, leading to the overproduction of dysfunctional antibodies, which can crowd out healthy blood cells, hamper immune function, and gradually damage various organs in the body.

Is Multiple Myeloma a Fatal Disease?

It is true that multiple myeloma is a serious and life-altering condition. However, in recent times, we have seen significant advancements in the field of multiple myeloma management, and patients are going back to leading fulfilling lives after their treatment.

The prognosis of multiple myeloma cancer depends on a myriad of factors, including the type of myeloma, its stage, the patient’s age, and the overall health status of the patient. Early-stage multiple myeloma cases are found to have a better prognosis than advanced-stage cases.

How Common is Multiple Myeloma?

Multiple myeloma is considered a relatively rare cancer compared to others, but its incidence varies by region and population. It has been observed that certain ethnicities and older individuals are at a higher risk. In India, multiple myeloma cancer is one of the less common types of cancer.

Understanding the risk factors of multiple myeloma cancer and seeking appropriate medical guidance to reduce its risk is the right way forward.

Book an Appointment

Different Types of Multiple Myeloma

There are different types of multiple myeloma based on their unique characteristics, such as the type of antibody chain they produce, their aggressiveness, growth rate, the line of treatment they demand, etc. The following are the important types of multiple myeloma:

Smoldering Multiple Myeloma (SMM)

SMM is an early, asymptomatic stage of myeloma. It is characterized by the presence of abnormal plasma cells in the bone marrow and elevated levels of M protein, but it does not exhibit the typical myeloma-related symptoms. SMM has the potential to progress to active myeloma over time, making regular monitoring essential for timely intervention.

Light Chain Myeloma

In this subtype, cancerous plasma cells produce only the light chains of antibodies rather than complete antibodies. Diagnosing light chain myeloma often requires specialized tests that focus on these abnormal proteins. Treatment approaches may need to be tailored to address the unique challenges presented by this subtype.

Non-Secretory Myeloma

Non-secretory myeloma is a rare form where the cancerous plasma cells do not produce the usual M protein, making it challenging to detect through standard blood or urine tests. Specialized diagnostic techniques, such as bone marrow biopsy and imaging, are often necessary to identify this subtype accurately.

Solitary Plasmacytoma

Solitary plasmacytoma is a localized form of myeloma that typically affects a single bone or soft tissue area. Unlike multiple myeloma, it is confined to one site and may not exhibit systemic symptoms. However, it can progress to multiple myeloma over time, necessitating careful monitoring and intervention.

Extramedullary Plasmacytoma

This subtype involves the growth of cancerous plasma cells outside the bone marrow, often in soft tissues or organs like the throat, nose, or lungs. Early detection is crucial to effectively managing extramedullary plasmacytoma, which may require a combination of treatments, including radiation therapy and surgery.

Monoclonal Gammopathy of Undetermined Significance (MGUS)

MGUS is a condition characterized by the presence of an abnormal protein (M protein) in the blood. Unlike multiple myeloma, MGUS does not cause symptoms or organ damage. While it carries a risk of progressing to myeloma or related conditions, many individuals with MGUS never develop cancer, highlighting the importance of ongoing monitoring and evaluation.

Immunoglobulin D (IgD) Myeloma

IgD myeloma is a rare subtype that produces immunoglobulin D antibodies. It tends to be more aggressive and may require specific treatment approaches, including chemotherapy and targeted therapies. Early diagnosis and appropriate management are crucial for addressing this rare but challenging form of the disease.

Immunoglobulin E (IgE) Myeloma

IgE myeloma is another infrequent subtype characterized by the production of immunoglobulin E antibodies. It presents unique challenges in diagnosis and management, with specialized tests often required for accurate identification.

Understanding the specific type of multiple myeloma cancer is paramount for tailoring an effective treatment plan and predicting disease progression. Ongoing medical evaluation and diagnostic tests are essential for accurate subtype identification and disease management.

Multiple Myeloma Cancer Stages

Multiple myeloma is staged based on the extent of the disease. However, the parameters considered for myeloma staging are slightly different:

The myeloma protein levels in the blood
The hemoglobin levels in the blood
The calcium levels in the blood
The presence of high-risk cytogenetic factors
The presence of bone lesions

Based on these factors, the following are the different stages of multiple myeloma:

Stage 1

Also known as early-stage multiple myeloma. This stage is characterized by low levels of monoclonal protein, or M protein, in the blood or urine. During stage 1, there may also be fewer cancerous cells in the bone marrow. The patients may have zero to mild symptoms.

Stage 2

This stage is more severe than stage 1. Patients may have moderate symptoms. The levels of M protein and cancerous cells in the bone marrow may vary.

Stage 3

Stage 3, or advanced-stage, multiple myeloma is characterized by higher levels of M protein in the blood and urine. Cancerous cells in the bone marrow are also high in number. Patients may have severe symptoms like bone pain, kidney problems, extreme fatigue, etc.

When to See an Oncologist?

If you experience symptoms like persistent bone pain, unexplained fatigue, frequent infections, or any signs of multiple myeloma, it's crucial to see an oncologist promptly. Early diagnosis and treatment can significantly improve outcomes.

Conclusion


Multiple myeloma, which is sometimes referred to as myeloma cancer of the blood, is a form of blood cancer that begins in the plasma cells. This is a rare condition; however, it can be managed effectively if it is caught in the early stages. There are various types of multiple myeloma based on certain unique characteristics they exhibit. Becoming aware of the crucial aspects of myeloma can help patients make informed decisions and put themselves a step ahead of this condition.

Frequently Asked Questions

What is high-risk multiple myeloma?

High-risk multiple myeloma typically refers to cases with certain aggressive features, such as specific genetic abnormalities or extensive disease involvement. These cases may have a less favorable prognosis and may require more intensive treatment strategies.

The staging of multiple myeloma is based on several factors, including the extent of disease involvement, levels of abnormal proteins, and the presence of symptoms. The widely used staging system is the International Staging System (ISS), which categorizes myeloma into stages I, II, and III based on these factors.

Stage 3 multiple myeloma indicates an advanced stage of the disease with a higher tumor burden and potentially more severe symptoms. However, the prognosis varies among individuals, and advancements in treatment have improved outcomes for many stage 3 myeloma patients.

The primary difference between Stage 1 and Stage 2 multiple myeloma is the extent of disease involvement. Stage 1 typically indicates early disease with fewer myeloma cells and less organ damage, while Stage 2 represents a more advanced stage with moderate disease involvement.

Yes, multiple myeloma is treatable, and there have been significant advancements in therapies for this condition. Treatment options include chemotherapy, targeted therapies, immunotherapy, stem cell transplantation, and supportive care. The choice of treatment depends on factors like the patient's overall health and the stage and subtype of myeloma.

Obesity is considered a risk factor for multiple myeloma, as it has been associated with an increased likelihood of developing the disease. However, cancer development is multifactorial, and obesity is just one of several potential risk factors.

Hyperdiploid multiple myeloma refers to a specific type of myeloma wherein the cancerous plasma cells have more than 46 chromosomes, which is the normal number of chromosomes in healthy cells. In other words, this condition causes the cancerous plasma cells to have extra copies of certain chromosomes. Chromosome numbers 3, 5, 7, 9, 11, 15, 19, and 21 are commonly affected.

Hyperdiploid multiple myeloma is reported to have a better prognosis, and the suitable treatment for it is decided upon considering factors like its type, stage, and the patient’s overall health condition.