 | Author(s) | | | Smith, P. Cox, CL and Kelly, D |
| Publication | | | Cancer Nursing Practice |
| Reference | | | volume 6 number 1: pages 25-28 |
| Publication Date | | | February 2007 |
|  |  Relevant to nurses who care for patients with multiple myeloma
This article gives an overview of the disease including clinical features, diagnosis, treatment options and likely outcomes. A case study helps to illustrate the impact of the disease on the individual.
Multiple myeloma is a haematological malignancy or bone marrow cancer that produces an excess amount of plasma cells, osteolytic bone lesions and monoclonal proteins that may be seen in the blood or urine. This results in a significant reduction in the normal production of plasma cells resulting in a compromised immune system and recurrent infection.
Common clinical features are bone pain and pathological fractures, anaemia and bone marrow failure, renal impairment and infection. Multiple myeloma represents only 1 per cent of all cancers and is more common in Afro Caribbean ethnic groups.
Myelomas are usually described in terms of secretory and non secretory, symptomatic and non symptomatic or smouldering and result in an unpredictable path for patients with numerous periods of relapse and remission.
Diagnosis is usually based on the presence of a Para protein spike (monoclonal protein or M Band) in the serum or urine sample, the presence of lytic bone lesions and more than 10% plasma cells in the bone marrow.
Patients are usually treated with chemotherapy initially with single agents. Autologus stem cell transplant is recommended in newly diagnosed patients up to the age of 65. The aim of treatment is to slow down the disease progression and improve the patient’s quality of life although medical intervention prior to the onset of symptoms has not proved to be beneficial. Radiotherapy may be used for lytic lesions and transfusions or erythropoietin may be given to treat anaemia.
More emphasis could have been given on the impact of bisphosphonates in myeloma therapy which is now standard treatment alongside chemotherapy
The article concludes with a case study followed by discussion that identifies multiple myeloma as being different to other cancers as being a haematological malignancy, having a significant presence of bone disease. A median survival of three to four years and currently no cure.
Comment by: Dr Sue Allen, Dean at the School of Health, University of Northampton
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