What are the symptoms of multiple myeloma? How can it be prevented?

Multiple myeloma (MM) is a malignant disease characterized by the abnormal proliferation of monoclonal plasma cells in the bone marrow. MM is more common in middle-aged and elderly people, mostly between 50 and 60 years old, with more men than women, with a male-to-female ratio of about 2:1. MM has a slow onset and can be asymptomatic for months to years. Common symptoms include anemia, bone pain, low fever, bleeding, infection, and renal insufficiency. As the disease progresses, hepatosplenomegaly, lymphadenopathy, repeated infections, bleeding, hyperviscosity syndrome, and renal failure may occur. MM accounts for 1% of all tumors and 10% of blood tumors. The natural course of the disease is 0.5 to 1 year, and survival is significantly prolonged or long-term "disease-carrying survival" after treatment.

What are the clinical manifestations of multiple myeloma?

1. Clinical manifestations caused by MM tumor cell infiltration

(1) Bone pain, bone deformation and pathological fractures: Bone pain is the most common early symptom, accounting for about 70%, mostly pain in the lumbar sacral, sternum and ribs. Pathological fractures can exist in multiple places at the same time. Myeloma infiltration of bones can cause local masses. In a few cases, only a single bone is damaged, which is called solitary myeloma. (2) Anemia and bleeding: Anemia is more common and is the first symptom. Early anemia is mild and later anemia is severe. Thrombocytopenia and bleeding symptoms are common, and skin and mucous membrane bleeding is more common. In severe cases, visceral and intracranial bleeding may be seen. (3) Extramedullary infiltration: Extramedullary infiltration is more common in the liver, spleen, lymph nodes and kidneys. The liver and spleen are mildly or moderately enlarged, the cervical lymph nodes are enlarged, and myeloma kidneys. Neural infiltration can cause some patients to experience limb paralysis, drowsiness, coma, diplopia, blindness, and decreased vision in the early or late stages. If there are polyneuropathy (P), organomegaly (O), endocrinopathy (E), monoclonal immunoglobulinemia (M) and skin changes (S) at the same time, it is called POEMS syndrome. Isolated lesions only seen in soft tissues are called extramedullary myeloma. MM can develop into plasma cell leukemia.

2. Symptoms caused by myeloma cells secreting large amounts of M protein

(1) Secondary infection: Due to the decrease in normal polyclonal immunoglobulins and neutropenia, MM patients are prone to infection, which is mostly caused by bacteria, but also fungi and viruses. The most common ones are bacterial pneumonia, urinary tract infection, and sepsis. Viral infection is more common in herpes zoster. (2) Renal function damage: 50%~70% of patients have protein, red blood cells, white blood cells, and casts in urine tests, and they develop chronic renal failure, hyperphosphatemia, hypercalcemia, and hyperuricemia, and may form uric acid stones. (3) Hyperviscosity syndrome: The incidence rate is about 2%~5%, which is caused by increased plasma viscosity, slow blood flow, tissue congestion, and hypoxia. Dizziness, blurred vision, and sudden syncope and impaired consciousness may occur. (4) Amyloidosis and Raynaud's phenomenon: The incidence rate of amyloidosis is 5%~10%, and it often occurs in the tongue, skin, heart, gastrointestinal tract, skin, ligaments, etc. If the M protein is cold globulin, it can cause Raynaud's phenomenon.

What are the causes of multiple myeloma?

Genetic factors: Myeloma has a certain familial inheritance and may be related to chromosomal abnormalities.

Ionizing radiation: High doses of ionizing radiation can cause myeloma. Those exposed to air radiation greater than 1Gy have a 5-fold increased risk of developing myeloma.

Chronic antigen stimulation: such as cholecystitis, rheumatoid arthritis, repeated allergen injections, etc. are high-risk factors for myeloma.

Viral Infections: Viral infections may activate oncogenes.

How to prevent it in daily life?

Strengthen your physical fitness, maintain a regular work and rest schedule, and don’t stay up late!

Eat healthy food and avoid eating overheated, overcooled, expired or spoiled food.

Participate in appropriate exercise to reduce decalcification.

Stay away from harmful chemicals, radiation and carcinogenic factors.

Have regular physical examinations, actively treat chronic diseases, pay attention to personal hygiene, and prevent infection.