HJNO May/Jun 2024

50 MAY / JUN 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS ONCOLOGY DIAL GUE COLUMN ONCOLOGY Introduction Multiple myeloma (MM) is a cancer of plasma cells in the bone marrow. Normally, plasma cells produce antibodies and play a key role in immune function. However, uncontrolled growth of these cells leads to bone pain and fractures, anemia, infections, and other complications. In the U.S., about 4 people per 100,000 are diagnosed with MM each year. This condi- tion is slightly more common among men than women andmore common among Black Americans. The average age at diagnosis is 65 to 70 years. The current treatment options for MM include watchful waiting (for smoldering multiple myeloma), chemotherapy, stem cell transplantation, and chimeric antigen receptor T cell (CAR-T) therapy. Multiple my- eloma is seldom cured, although treatment can relieve symptoms, induce a sustained period of remission, and prolong life. The cause of MM is unknown. Exposure to radiation, organic chemicals (such as ben- zene), herbicides, and insecticides may play a role. Genetic factors and viral infectionmay also influence the risk of developing multiple myeloma. Symptoms • Anemia. • Elevated calcium. • Bone pain/lesions. • Kidney dysfunction. • Infections. • Neuropathy. • Neurological symptoms, including headaches and vision disturbance. • Bleeding, weight lost, bruises, skin rash. Diagnosis • Blood/24-hour urine test to detect monoclonal protein (M Protein). • Free light chains — protein levels of kappa, lambda, and their ratio. • Immunoglobulins levels. • Bone marrow biopsy with flow cytom- etry, cytogenetics, chromosomal analy- sis, FISH, next generation sequencing. • Whole body PET scan or MRI to detect bone lesions. Criteria for diagnosis: Abone marrow aspirate or biopsy showing that at least 10% of the cells are plasma cells or the presence of a plasma cell tumor, called a plasmacytoma, plus either the evidence of damage to the body as a result of the plas- ma cell growth (such as severe bone damage, kidney failure, anemia, or high calcium in the Multiple Myeloma I N 2024