Leukaemia Foundation

Leukaemia, Lymphoma, Myeloma & Related Blood Disorders.

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What is it?

Myeloma, also known as multiple myeloma, is a cancer of plasma cells. Plasma cells are mature lymphocytes, a type of white blood cell, that help fight infection by producing special proteins called antibodies or immunoglobulins. In myeloma, large numbers of abnormal plasma cells called myeloma cells are made in the bone marrow. These myeloma cells multiply abnormally, without any proper order, forming collections known as tumors that accumulate in different parts of the body, especially in the bone marrow and on the surfaces of different bones in the body. These tumours secrete chemicals that stimulate other bone marrow cells (osteoclasts) to remove calcium from the bone. As a result bones can become weaker, more brittle and prone to breakage. They also collect in the bone marrow preventing it from making normal red cells, white cells and platelets. Over time people with myeloma can become anaemic, more susceptible to infections and to bleeding and bruising more easily.

Myeloma cells typically produce an abnormal type of immunoglobulin called paraprotein or M protein, which can be detected in the blood and urine. Excessive amounts of paraprotein can cause problems in the body, such as kidney damage.

How common is it?

Each year in Australia around 1,500 people are diagnosed with myeloma.

Who gets it?

The risk of developing myeloma increases with age. Almost 80% of all new cases are diagnosed in people over the age of 60. Myeloma is uncommon in people under 40. It occurs more frequently in men than in women.

What causes myeloma?

The cause of myeloma remains unknown but it may result from damage to one or more of the genes that normally control blood cell development. In a small number of cases, exposure to high doses of radiation and ongoing exposure to certain industrial or environmental chemicals may increase the risk of myeloma. Some people with monoclonal gammopathy of undetermined significance (MGUS), a non-malignant (non-cancerous) condition, will eventually go on to develop myeloma.

What are the symptoms?

The most common symptom of myeloma is bone pain. This is usually felt in the back or ribs and may be made worse by movement. Other symptoms are caused by a lack of normal blood cells and include:

  • anaemia, due to a lack of red cells; causing persistent tiredness, dizziness, paleness, or shortness of breath when physically active,
  • frequent or repeated infections and slow healing, due to a lack of normal white blood cells, especially neutrophils,
  • increased or unexplained bleeding or bruising due to a very low platelet count.

How is it diagnosed?

Myeloma is diagnosed using information gathered from a number of different tests. These include a physical examination, blood and urine tests, a bone marrow biopsy, x-rays and other more specialised bone imaging tests.

How is it treated?

The treatment for myeloma depends on a number of factors including the stage of your disease, your general health and your age. Although there is currently no cure for myeloma, treatment can be successful in controlling the disease, sometimes for several years.

People diagnosed with early stage disease, smouldering myeloma, don't have any symptoms and don't need treatment straight away. Treatment may be given at a later stage, when the disease progresses after some months or years. In these cases the doctor may recommend regular checkups, including blood and urine tests, to carefully monitor their health.

Chemotherapy, usually in combination with cortico-steroids, may be given to control the growth of myeloma. Treatment is given until the myeloma reaches a stable or plateau stage, where the amount of myeloma in the body is reduced to as low a level as possible. Once the myeloma is controlled more treatment is needed to prolong the remission for as long as possible. There are several treatments used, including cortico-steroids (prednisone / prednisolone), interferon and thalidomide. Thalidomide may also be used in the initial treatment of myeloma and to control myeloma that has come back (relapsed).

There are several options for treating relapsed myeloma. These include more chemotherapy, thalidomide and bortezomib (Velcade®).

Drugs called bisphosphonates are commonly used to prevent and treat complications due to bone damage. These drugs can help to re-strengthen the bone and reduce risk of fractures, therefore protecting them from the damaging effects of myeloma. By preventing bone destruction, these drugs also help to reduce bone pain, and hypercalcaemia (excess calcium in the blood), which can result from bone breakdown.

High dose chemotherapy followed by stem cell transplantation is used to treat some people with myeloma, who have no other serious illnesses. Promising new and experimental treatments are being developed all the time. Some of these treatments are currently being used in clinical trials in Australia and other parts of the world. Your doctor will be able to discuss with you all of the treatment options suitable for you.

Side-effects of treatment

All treatments can cause side-effects. The type and severity however will vary between individuals, depending on the type of treatment used and how an individual responds to it. In general, more intensive treatment is associated with more severe side-effects. It is important to report any symptoms you are having to your doctor or nurse. In most cases they can be treated and are reversible.

Your doctor and nurse will discuss with you the possible side-effects of any treatments you need and how they can be managed.

Smouldering (asymptomatic) myeloma

Read More about: Smouldering (asymptomatic) myeloma

Solitary plasmacytoma

Plasmacytoma refers to a tumour consisting of abnormal plasma cells that grows within the soft tissue or bony skeleton.

Read More about: Solitary plasmacytoma

Monoclonal gammopathy of unknown significance (MGUS)

MGUS is a condition characterised by the presence of an abnormal protein in the blood that is produced by plasma cells.

Read More about: Monoclonal gammopathy of unknown significance (MGUS)

National Myeloma Day 2014

Read More about: National Myeloma Day 2014

Ladies and gentlemen – start your engines! 52 muscle cars - nine days - 3,100km

Publish Date: 30/9/2014

Aussie Muscle Car enthusiasts are in count down mode for Friday, October 31, when the days of Bathurst 1963 to 1977 are temporarily replicated on the Clipsal 500 Adelaide start grid. The 2014 Aussie Muscle Car Run is set to showcase 52 magnificent muscle cars revving and ready for the nine day, 3,100km cruise .

Read More about: Ladies and gentlemen – start your engines! 52 muscle cars - nine days - 3,100km

New psychosocial program prepares regional people for bone marrow transplant

Publish Date: 30/9/2014

Generous community support enables the Leukaemia Foundation to award Professional Development Grants to professionals like Simone Rutley, a medical oncology social worker. The opportunity to learn more about the psychosocial implications of relocating regional people for bone marrow transplant is a valuable one and improves quality of care for regional Australians.

Read More about: New psychosocial program prepares regional people for bone marrow transplant

Volunteer spotlight: Inspiring young people to volunteer for the Foundation

Publish Date: 30/9/2014

Laura Newell was just nine years of age when she started volunteering for the Leukaemia Foundation. A cause very close to her heart after losing her dad to blood cancer, Laura has demonstrated that age is no barrier in becoming a volunteer to help raise awareness and vital funds for research into a cure for blood cancer.

Read More about: Volunteer spotlight: Inspiring young people to volunteer for the Foundation

Annual Blood Cancer Conference proves informative and fascinating

Publish Date: 30/9/2014

Read More about: Annual Blood Cancer Conference proves informative and fascinating

Get your blood pumping with the inaugural Victorian Trail Running Festival

Publish Date: 30/9/2014

Victorian trail runners have never had it so good! The inaugural Victorian Trail Running Festival, the first event of its kind in Australia, is calling all trail runners together for an adventurous three day trail run through the Yarra State Forrest.

Read More about: Get your blood pumping with the inaugural Victorian Trail Running Festival