Multiple Myeloma: Epidemiology, Pathogenesis, Outcomes, Treatments and Prognosis

Running Head: CANCER CAUSING ISSUES
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Multiple myeloma
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CANCER CAUSING ISSUES
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Multiple myelomas
Multiple myelomas are defined as the blood cancer that caused by lymphoma and
leukaemia [1]. This disease cannot be treated or cured, however, it can be slows down and
the person with this health issues can live longer. In this disorder, the white blood cells
multiply abnormally. The plasma cells become carcinogenic and keep dividing and growing
abnormally. These plasma cells produce impaired protein or antibodies such as monoclonal
protein. The risk factors associated with this disease include age (being old), African –
American people are more likely to develop, genetic factors (one of the facility members
have this disorder), and someone with plasma cell disease like Solitary plasmacytoma. It does
not show Symptoms at early stages, however after some time it shows symptoms like bone
pain, weight loss, weakness and fatigue [2]. In this essay, the epidemiology, pathogenesis,
outcomes of the untreated condition, treatments and current prognosis with therapy will be
discussed
Multiple myelomas are the second most commonly found haematological malignancy
after lymphoma. It accounts for one percent of all type of cancer. Particularly in 2016 early
24, 2802 to 230,330 new patients have been diagnosed and 12, 650 deaths have occurred.
The estimated global five years prevalence is nearly 230,000 people with this health issue [3].
According to the American society of cancer it is estimated in 2018 that nearly 30, 770 new
patients will be diagnosed and around 12, 770 deaths are expected to occur. In the western
world, 37 per cent of the patient diagnosed with multiple myeloma belongs to the age group
of 66-70 years. This disease is rare in the people with 30 or below age. A study conducted by
myeloma incident by Baker reported that nearly 86000 incidents occur annually and nearly
63000 people are died due to this disorder each year. Geographically the frequency of
occurrence of this disease is higher in industrialized areas of New Zealand/Australia, North

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America, and Europe [4]. In Australia, nearly 1500 cases are identified with these issues each
year. According to a report published by Cancer Australia in 2013 to 12014 nearly 1637 new
cases have been diagnosed, it was also estimated that close 1876 new case will be diagnosed
in 2018 [5].
The pathogenesis of multiple myeloma is a complex progress that can be divided into
different stages. Multiple myelomas have been characterized by the multiplication of plasma
cells which involve in more than 10 percent of the total bone marrow. The bone marrow
microenvironment of the tumor cells plays a key role in the pathogenesis of the myelomas.
Plasma cells and the plasmacytoid lymphocytes are considered as the most mature cells of B
lymphocytes. The maturation of B cell is related to programmed rearrangement of a DNA
sequence in order to encode the structure of the mature immunoglobulins. It can be
characterized by the overproduction of IgG, IgA [6]. IL or interleukin 6 and IL-1b are also
the important factor responsible for in vitro growth of myeloma cells [8]. The pathogenesis of
this disease includes a skeleton process, hematologic, renal and nervous system process. In
the skeleton process, the plasma cell proliferation leads to extensive skeleton destruction. The
isolated plasmocytomas cause hyperkalemia with the production of osteoclast-activating
factors. The hematologic process includes the M components interaction with clotting factor
leads to defective aggregation. The renal injury in multiple myeloma involved plasmacytoma,
the renal infiltration of the plasma cells causes myeloma and glomerulosclerosis.
The general process of multiple myeloma includes hyper-viscosity syndrome. This
syndrome occurs with the abnormal production of IgG1, IgG3, or IgA. The B- lymphocytes
in bone marrow move to the lymph. With progression, they mature and show different
protein on their cell surface. They start secreting antibodies after activation. These cells
develop MM when they left the germinal center of the lymph node. The immune system