Bone marrow aspirate cytology of multiple myeloma, a type of bone marrow cancer of malignant plasma cells associated with bone pain, fractures, and anemia. (Source: Shutterstock)
Multiple Myeloma (also known as "plasma cell myeloma", "Kahler’s disease" after Otto Kahler or "Huppert’s disease") is a cancer of the bone marrow. It is characterized by malignant multiplication of antibody-producing cells, the so-called plasma cells. The degenerated plasma cells typically produce antibodies or fragments of it. Since all malignant (i.e. malignant) plasma cells are descended from a common precursor cell, they are genetically identical (cell clone) and produce identical (i.e. monoclonal) antibodies.
The extent of the malignancy can vary ranging from pre-cancerous lesions in slowly progressing disease processes, to highly malignant, rapidly fatal without treatment, leading to death. What is striking is that plasmacytoma occurs mostly in men over the age of 60. It is unclear why plasmacytoma occurs twice as often now than 30 years ago.
Patients complain of fatigue and weight loss, and often pain in the back of the head. The indication of bone pain help the diagnosis (often back pain). This, in contrast to the pain of bone metastases is not at night, but increases during movement with the occurrence of spontaneous fractures. Through the growth of B cells in the bone marrow, there is a dissolving of bone substance and therefore a loss of stability. This grouping in the skull bones is relatively common and typical and referred to as a» pepper-pot-skull.
Characteristic of Multiple Myeloma is a proteinuria (protein in urine) which can eventually lead to damage of the kidneys in addition to an increased excretion of calcium (bone loss). The repression of growth in the bone marrow can cause anaemia, leuco-and thrombocytopenia. An increased vulnerability to infection and clotting disorders can also occur, which becomes apparent through skin bleeding or increased nosebleeds.
The diagnosis is made by blood tests, X-rays of the large bones, and bone marrow biopsy.