Multiple myeloma is the malignant proliferation of plasma cells involving more than 10 percent of the bone marrow. Bone pain related to multiple lytic lesions is the most common symptom of multiple myeloma. However, many patients are diagnosed incidentally while being evaluated for unrelated problems, and one third of patients are diagnosed after a pathologic bone fracture.
     Continuous bone destruction is the hallmark of multiple myeloma. The spine is the most afflicted skeletal organ, and vertebral fractures significantly contribute to its poor outcome. The principal underlying pathologic mechanism causing bone disease in multiple myeloma is a shift in the balance of bone formation and bone resorption toward bone resorption. During the past decade bisphosphonates have become an important adjunctive treatment in the management of multiple myeloma.

Multiple Myeloma Treatment
Chemotherapy with melphalan-prednisone is the standard treatment for multiple myeloma. Other treatment modalities include polychemotherapy and bone marrow transplantation. Only 50 to 60 percent of patients respond to therapy.
     Treatment of patients with multiple myeloma has advanced over the past few decades. Autologous stem cell transplantation appears to be the "gold standard" of front-line treatment in young patients. The best innovative therapeutic concept is illustrated by the new molecules that target both the myeloma cells and the bone marrow microenvironment. The issues of maintenance therapy and allogeneic stem cell transplantation in the treatment of patients with myeloma remain to be addressed.

Stem Cell and Multiple Myeloma Treatment
Autologous stem cell transplantation is currently considered the standard of care for younger patients with newly diagnosed multiple myeloma based on several randomized trials that have shown it is superior to conventional chemotherapy. However, the introduction of novel agents like thalidomide, bortezomib, or lenalidomide may improve the results of standard-dose therapy. For instance, in combination, melphalan/prednisone/thalidomide may yield a good response comparable with those achieved with ASCT. However, recent research disputes that the effectiveness of the thalidomide addition as therapeutically beneficial.

Thalidomide and Multiple Myeloma Treatment
Thalidomide, a drug that caused ghastly birth defects a generation ago but has been resurrected in recent years as a promising cancer treatment, failed in a study to prolong the lives of patients with multiple myeloma. Other studies have found thalidomide helped myeloma patients both early on and when given after they relapsed or didn't respond to standard treatments. But a large study done by researchers at University of Arkansas for Medical Sciences found that in newly diagnosed multiple myeloma patients given thalidomide on top of an already-grueling chemotherapy regimen, the thalidomide eventually stopped working, and those patients rapidly declined and died.

Multiple Myeloma symptom and sign
Signs and symptoms of multiple myeloma include bone pain, bone fractures, weakness, anemia, infection (often resulting from pneumococcal infection), hypercalcemia, spinal cord compression, or renal failure. Sometimes, on a routine blood test, a large gap between the total protein and the albumin levels suggests a problem (ie, protein minus albumin equals globulin). The multiple myeloma cell produces monoclonal immunoglobulins that may be identified on serum or urine protein electrophoresis.

Multiple Myeloma prognosis
The average survival rate for all stages of multiple myeloma is about three years.

Differential Diagnosis of Multiple Myeloma
Multiple myeloma must be differentiated from other causes of monoclonal gammopathy, including monoclonal gammopathy of undetermined significance, heavy chain disease, plasmacytoma and Waldenstrom macroglobulinemia.

Multiple Myeloma Cause
Firefighters appear to have higher-than-average rates of several types of cancer including prostate and testicular cancers, as well as the immune system cancers non-Hodgkin's lymphoma and multiple myeloma.

Smoldering myeloma
A diagnosis known as smoldering multiple myeloma cna be considered when symptoms and signs point to something between monoclonal gammopathy of undetermined significance and overt multiple myeloma. Smoldering myeloma is generally defined as greater than 10% plasma cells in the marrow and an M serum protein of greater than 3g/dL. In most cases, serum creatinine and calcium levels are normal in smoldering myeloma.