Myeloma: symptoms, prognosis and treatment
Myeloma( plasmacytoma) is a malignant( oncological) disease.When it is degenerated, the plasma cells responsible for human immunity are present in the bone marrow and in the blood( B-lymphocytes).
Myeloma is most often diagnosed in the elderly( 50-70 years);In patients younger than 40 years this type of cancer is extremely rare.The incidence among men is slightly higher.The causes of myeloma development are not yet clear.
Important: in some patients in the laboratory blood test, long before the onset of symptoms, there is a so-called.M-component, which is an abnormal protein compound.It is believed that the presence of this protein in the body significantly increases the risk of developing plasmacytoma.Table of Contents:
Symptoms of myeloma
In the early stages of myeloma, there may be no manifestation, i.e., possibly an asymptomatic course of the process.With a plasmacytoma, a single tumor is not formed;Degenerated cells are found in the bone marrow literally everywhere
Note: The tumor, formed with myeloma outside of the bones, was called the solitary plasmacytoma.Sometimes such malignant neoplasms can be multiple.
Most often the first symptoms of myeloma development are increased physical fatigue, general weakness and progressive weight loss .Diseases of infectious and inflammatory genesis against the background of oncology take longer and harder, as the damage to plasmocytes causes a sharp decrease in immunity.In some cases, patients complain of impaired functional kidney function.
Among the most common clinical manifestations of this malignant disease is bone pain, more often in the spine.The immediate cause of the pain syndrome is compression( compression trauma) of the vertebrae.If the tissue is displaced and the vertebral canal is damaged, paralysis of the patient is not excluded.
Important: myeloma also often infects bones of extremities( especially tubular), pelvis and skull.
As the bone tissue actively loses calcium on the background of the development of the plasmacytoma, osteoporosis is often detected, and in the course of laboratory diagnostics an increased content of this mineral element in the blood( hypercalcemia) is determined.The combination of high concentrations of calcium with paraprotein( M-component) often leads to kidney damage with the development of their dysfunction( insufficiency).
Other possible signs of calcium leaching:
- development of coma.
Note: kidney damage is characteristic of more than 50% of patients suffering from myeloma.
When analyzing blood, anemia and a significant increase in ESR are detected( up to 80-90 mm / h).
A detailed picture of the pathology is characterized by the appearance of leukopenia( the number of neutrophils decreases).Myeloma cells can be found in the blood.
With myeloma, the viscosity of the blood usually increases, which is accompanied by the appearance of neurologic symptoms.
- numbness and paresthesia of the limbs;
- sensation of "goosebumps" or tingling in the hands and feet.
In the vast majority of cases, myeloma is diagnosed by accident .Usually it is revealed in the course of a general examination, which conducts to establish the causes of anemia or an increase in the rate of erythrocyte sedimentation.
Important: slow progression over many years is observed in 10% of cases.
In order to verify the diagnosis, tissue is taken for histological and cytological examination( biopsy) and an analysis is made of the blood content of the pathological protein.Pathological foci in the bones are detected during fluoroscopy.
Treatment of myeloma and prognosis
Modern methods of treatment can significantly reduce the severity of clinical symptoms and even achieve a complete remission.This cancer can sometimes be brought to a state close to the chronic course.In such cases, therapy is resumed only in case of an exacerbation.
With asymptomatic flow, a normal level of calcium in the blood and no problems with the kidneys, treatment is often postponed, limited to regular monitoring of the patient's condition.
Currently, myeloma is considered incurable, but early diagnosis and timely initiated adequate therapy can increase the life expectancy of cancer patients from one and a half to two years in the absence of treatment to four or more.
Note: is considered by some oncologists to initiate therapy, accompanied by a number of side effects, in the absence of clinical symptoms it makes no sense. Expectant tactics are justified in the I stages A and II A.
The main method for treating myeloma is pharmacotherapy.Doses and combinations of drugs are selected for each patient purely individual .As a rule, high doses of the hormone cortisone are prescribed.With the growth of the tumor mass in parallel, the patient receives other chemotherapy drugs, characterized by high antitumor activity.
The standard chemotherapy regimen assumes the following chemotherapeutic agents:
- Chlorobutin( + Prednisolone).
Important: the most powerful agents in this group are Talidamide, Velcade, Lenalidomide and Bortezomib.
The course duration is 4-7 days, it is repeated every 1.5-2 months.
If necessary, radiotherapy courses are prescribed.Indication for radiation therapy is a single plasmacytoma.
A patient with a diagnosed plasmacytoma is recommended to use drugs to strengthen bones( including calcium and vitamin D preparations).A high level of physical activity is of great importance for strengthening bone tissue.
The level of calcium in the blood slightly reduces glucocorticoids.With osteoporosis, drugs of male sex hormones, androgens, help fight.
To prevent serious kidney damage in myeloma, it is possible, taking allopurinol and strictly observing the drinking regimen.In acute functional failure of this organ, plasmapheresis and hemodialysis are shown to purify the blood from toxic metabolic products.
To prevent diseases of infectious genesis, it is necessary to take immunostimulants, immunomodulators and antimicrobial agents.
In order to reduce the intensity of the pain syndrome in later stages of myeloma, palliative therapy is prescribed strong painkillers( including narcotic analgesics).
If the patient is in normal physical form and his age is less than 70 years, allogeneic transplantation is practiced. This intensive care technique involves the sampling of the patient's own stem cells, and the subsequent introduction of the stem cells to the patient.
Myeloma therapy is usually performed on an outpatient basis, that is, at home with periodic examinations at a polyclinic at the place of residence.
Совинская Елена, medical reviewer