Myeloma: from Deadly to Chronic

Thanks to medical innovation, multiple myeloma patients are living longer than ever before.

Multiple myeloma (MM) is the second most commonly diagnosed blood cancer, after non-Hodgkin lymphoma, yet few people know much about this deadly disease. Approximately 22,000 Americans were diagnosed with MM in 2013. In the United States, nearly 74,000 have MM, and an estimated 10,700 will die from the disease this year. Globally, it’s estimated that 103,000 people were diagnosed with MM in 2008, which equates to 12 percent of all blood cancers diagnosed, according to Cancer Research UK.

“Myeloma is important because it’s increasing in incidence,” Brian G.M. Durie, MD, chairman and co-founder of the International Myeloma Foundation, said at the American Society of Hematology (ASH) Annual Meeting in New Orleans in December 2013. “There are more patients around the world being diagnosed with myeloma, and for some reason it’s being diagnosed in patients who are younger.”

The reason behind this increase is unclear. What we do know is that MM is a cancer in which plasma cells—an important part of the immune system—become immortal and eventually replicate uncontrollably and accumulate in the bone marrow, the soft tissue at the center of the bones. The cancer cells grow out of control, crowding out normal cells.

The signs and symptoms of multiple myeloma at early stages of the disease are subtle. But as the disease progresses it can cause effects such as bone destruction, anemia (a lack of red blood cells) or even kidney failure. Many people with MM experience debilitating bone pain and fractures that require radiation or surgery. Bone fractures can be particularly dangerous when they occur in the spinal column, causing the vertebrae to collapse or compress, damaging the spinal cord. In some cases, paralysis can occur. Patients may also experience weight loss, numbness or weakness in the legs and repeated infections such as pneumonia, shingles or sinusitis.

While the cause of multiple myeloma is unknown, several risk factors increase the odds of developing it, including radiation exposure and even farming. MM is twice as common in African Americans compared with Caucasians and is significantly more common in patients who have a close relative with the disease. However, most patients with MM have no known risk factors other than age. On average, MM patients are 70 years old at diagnosis.

There is currently no cure for multiple myeloma, but medical advances are helping make progress on this front. Since the introduction of novel, innovative therapies in the 1990s, survival times have improved by an impressive 300 percent—from a median survival of 2.5 years after diagnosis in 1997 to more than 10 years in 2012. Between 2000 and 2009, the United States saw a 73 percent increase in the number of myeloma survivors. As survivorship increases, researchers are hoping they can do even better, by making myeloma a chronic condition like other incurable diseases such as diabetes and hypertension. “We are able to discuss the idea that we are attempting to cure myeloma,” Dr. Durie said at ASH.

In the interim, a lot of headway has been made in improving the prognosis for patients with MM, but there is still a need for earlier diagnosis and new treatment options.

“The treatment of myeloma is at a unique crossroads, as the work that has been done has created a positive foundation for patient outcomes,” Mohamad Hussein, MD, vice president of Global Scientific Affairs, Multiple Myeloma for Celgene, said. “We also have the opportunity through our commitment to a new understanding of the disease to get closer in the coming years to our goal of turning this incurable cancer into a chronic, manageable condition.”

Impressive numbers such as these are yet another reason why we must continue to support medical innovation. They are proof that even progressive improvements can add up to make real differences in people’s lives.