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Understanding Multiple Myeloma with Dr. Ackerman

Scot Ackerman , M.D.

October 22, 2021

Understanding Multiple Myeloma

Former US Secretary of State, Colin Powell, passed away at the age of 84 this past Monday. Mr. Powell was being treated for multiple myeloma, which is a relatively uncommon cancer of bone marrow cells.

According to the American Cancer Society, about 35,000 new cases will be diagnosed in 2021. Dr. Scot Ackerman joined WJXT to discuss symptoms, risk factors, screening, and treatment options to be aware of for multiple myeloma.

Presenting Symptoms of Multiple Myeloma: Multiple myeloma can present itself in a handful of ways, including the following:

  • Low blood count- Can cause anemia, increased bruising and bleeding, and leukopenia.
  • Bone and calcium problems- Myeloma cells make a substance that tells osteoclasts to speed up dissolving the bone. This increase in bone break-down can also raise calcium levels in the blood.
  • Infections- Myeloma cells crowd out normal plasma cells so that antibodies that fight infection can’t be made.
  • Kidney problems- Myeloma cells make an antibody that can harm the kidneys, leading to kidney damage and even kidney failure.

Risk Factors: The most common risk factors include but are not limited to:

  • Age- Most people diagnosed are > 65 years, < 1 % diagnosed are younger than 35
  • Gender- Men are slightly more likely to be diagnosed.
  • Race-  Two times as common to be diagnosed if you are African American/Black rather than white.
  • Family history- More likely to be diagnosed if immediate family member has been diagnosed.
  • Having other plasma diseases- Monoclonal Gammopathy of Undetermined Significance (MGUS) or Solitary Plasmacytoma are at higher risk.

Screening and Tests: There are a variety of screening methods and tests available, the following are performed most frequently:

  • Lab tests- Blood counts, blood chemistry tests, urine tests, quantitative immunoglobulins, electrophoresis, serum free light chains
  • Biopsies- Bone marrow biopsy, fine needle aspiration biopsy, core needle biopsy
  • Imaging- X-ray, CT, MRI, PET, ECHO

Types of Myeloma:

  • Smoldering multiple myeloma- Early myeloma that isn’t causing any symptoms.
  • Active multiple myeloma- Full blown myeloma that exhibits symptoms and CRAB criteria- calcium (high levels), renal insufficiency, anemia, bone lesions

Treatment: It is important to discuss all of your treatment options with your physician prior to choosing. The following treatment options are most common and can be used at different stages of diagnosis:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Stem cell transplant (autologous or allogeneic)
  • CAR (chimeric antigen receptor) T-Cell Therapy

Survivorship: While multiple myeloma is curable, it is very important to continue follow up care and appointments with your physician to ensure cancer has not come back. Soemtimes, secondary cancer can occur. If you are receiving screening and follow-up care, these secondary cancers can be caught and treated early. People who have had multiple myeloma are at increased risk of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).

To view the full interview with Dr. Scot Ackerman and WJXT, click here

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