Multiple Myeloma and Osteoporosis

By December 12, 2017The Bone Bandits

What is Multiple Myeloma?

Multiple myeloma is a relatively rare form of cancer, accounting for less than 1% of all cancer diagnoses. The disease impacts 1 in 20,000 people and is most common in those age 50 and older. Multiple myeloma is a blood cancer involving the plasma cells produced in your bone marrow, which are responsible for key functions in your immune system. Most importantly, plasma cells make antibodies to fight infections. If you have multiple myeloma, your bone marrow is taken over by cancer cells that produce too much of a single type of antibody. Because so much effort is put into making this one antibody, the body has less resources to produce other important blood cells.

How is Multiple Myeloma Diagnosed?

If you have multiple myeloma, you will likely experience few symptoms early in the disease course. As the disease progresses, you may experience weight loss, fatigue, frequent infections, bone pain, and fractures—particularly those involving the spine and ribs.

To diagnose multiple myeloma, we typically use lab tests known as serum/urine electrophoresis, or a medical procedure known as a bone marrow biopsy. Other tests that provide useful information include your complete blood count, as well as beta-2 microglobin.

  • Serum/Urine Electrophoresis. These are our primary tools for diagnosing multiple myeloma. They provide a measure of the different types of antibodies (or immunoglobulins) in your blood and urine. Those with multiple myeloma will have very high levels of a single antibody.
  • Complete Blood Count (CBC). A CBC provides a detailed snapshot of the different types of cells in your blood. If you have multiple myeloma, you may have low levels of hemoglobin and other blood cells.
  • Beta-2 Microglobin. This is a protein produced by cancer cells. Higher levels indicate more severe disease and a worse prognosis.
  • Bone Marrow Biopsy. This is an invasive procedure that involves taking a sample of your bone marrow. Those with multiple myeloma will have too many plasma cells and some will have a plasma cell tumor called a plasmacytoma.

How Does Multiple Myeloma Impact Your Bones?

Myeloma cells release chemicals which can have detrimental effects on your bones. Over time, these chemicals cause bone breakdown and also decrease your body’s ability to produce new, healthy bone. This is supported by several studies which revealed those with multiple myeloma have elevated lab values for bone breakdown (including NTX, CTX) and decreased values for bone formation (including alkaline phosphatase, osteocalcin). This bone loss leads to osteoporosis, and 80% of people with the disease will ultimately experience a broken bone!

How Can Those With Multiple Myeloma Improve Their Bone Health?

Treatment by a blood cancer specialist can include chemotherapy, radiation, and stem cell transplants. To reduce your risk of breaking bones, bisphosphonate medications (including Fosamax, Actonel, and Reclast) have been used with considerable success. A 2012 study showed that use of bisphosphonates decreased your likelihood of breaking bones, and also decreased bone pain associated with the disease.