Myeloma & MGUS

Myeloma, also known as multiple myeloma, is a type of bone marrow cancer arising from plasma cells, which are normally found in the bone marrow. Bone marrow is the ‘spongy’ material found in the centre of larger bones in the body. As well as being home to plasma cells (which help your immune system), the bone marrow is the centre of blood cell production (red blood cells, white blood cells and platelets).

Normal plasma cells produce antibodies (also called immunoglobulins) to help fight infection. In myeloma, abnormal plasma cells release one type of antibody known as a paraprotein, which has no useful function. It is often through the measurement of this paraprotein that myeloma is diagnosed and monitored.

Myeloma affects multiple places in the body where bone marrow is normally active in adults, i.e. within the bones of the spine, skull, pelvis, the rib cage, and the areas around the shoulders and hips. Some people go on to develop myeloma after having previously been diagnosed with a condition called Monoclonal Gammopathy of Undetermined Significance (MGUS). 

MGUS is a condition with a detectable paraprotein (like myeloma) but with no associated symptoms. The risk of transformation from MGUS to active myeloma is very low  with only a 1% chance each year of follow-up. If there is an increase in the number of plasma cells in the bone marrow but without symptoms, a diagnosis of smouldering myeloma will be made. In most cases, treatment will not be required until either symptoms/complications develop or there is a high risk of symptoms/complications. It may be a number of years before a person with MGUS or smouldering myeloma requires treatment. Regular monitoring with a haematologist is required to initiate treatment when needed. 

Historically, treatments for myeloma used a combination of chemotherapy, steroids and high-dose therapy and stem cell transplantation. Recently, a range of newer therapies  have become available that aren’t traditional chemotherapy. Research is ongoing and many new drugs in this class are under development with new ones coming available each year. With the emergence of many new, more targeted treatments, survival rates have increased dramatically. 

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