MM disease, Multiple Myeloma

“MM disease” (MM), or by its full name, Multiple Myeloma, is a form of hematologic cancer that is not widely known. It is caused by an abnormality in the division of plasma cells, which originate in the bone marrow, leading to the production of abnormal proteins in the blood.

Normally, plasma cells function to produce immunity for the body. However, when a patient develops MM disease, the plasma cells are transformed into cancer cells and can no longer produce immunity normally. Instead, they produce M protein and secrete abnormal chemicals into the body, which cause abnormalities in the bone marrow as well as in other organs of the body.

In the early stage, the patient will not have any abnormal symptoms. Some may have only mild anemia, which makes it difficult to diagnose the disease correctly. In most cases, by the time MM disease is recognized, it has already progressed to stage 2 or 3, with symptoms of anemia, bone pain, osteoporosis, bone fractures, and high blood calcium, which is a stage at which treatment is considered difficult. Most MM cancer patients are first referred to the orthopedics or bone department, because the physical symptoms they present are body pain, back pain, osteoporosis, bone collapse, bone fractures, and so on.

This disease is common in adults, with an average age of about 60 years. It is found in Black people twice as often as in White people. In Asian countries, the proportion per 100,000 population is 0.8 patients in Singapore and 2 patients in Korea. As for Thailand, there are no clear statistical records.

Causes

The exact cause is still unknown. Genetic factors may be associated with HLA-Cw5 and HLA-Cw2. The cancer occurs in B-lymphocyte white blood cells in the lymph nodes. In 50 percent of patients, abnormalities of chromosome 14 are found. The cancer cells produce large amounts of IL-6, causing pathology throughout the body. In addition, it has been found that in areas with high radioactivity, such as areas where nuclear tests were conducted or that were struck by nuclear bombs, there is a higher proportion of patients with this disease.

Symptoms

1. It causes anemia, fatigue, easy tiredness, slow blood clotting, or problems with blood clotting.
2. Increased blood protein, causing kidney failure, leg swelling, and pallor.
3. Bone destruction, osteoporosis, bone fractures, bone pain, and collapse of the spinal cord.
4. Increased blood calcium, causing dehydration, fatigue, drowsiness, confusion, and constipation.
5. Reduced production of the body's immunity, making infection easy.

Causes of death

1. From infection due to a weakened immune system.
2. Anemia, low platelets, and bleeding in the brain.

Treatment

Most patients who come for treatment have symptoms at stage 2 or 3, because in the early stage of the illness, patients are almost unaware of it until physical symptoms appear, mostly bone pain, before they see a doctor, which is already considered a fairly dangerous stage of the disease. Chemotherapy is the most commonly used method, and radiation therapy may also be given to reduce pain from bone aches. There are several regimens of chemotherapy drugs available, and specialist doctors will arrange the drug regimen according to the disease symptoms, which is considered another hope for patients with this disease.

Prevention

MM disease is one of the diseases that is difficult to prevent, because it is not known when it will occur. To this day, there are still no research results studying the factors that cause the disease. Currently, all that can be done is a physical check-up, that is, a blood test every year or every 6 months. If pallor or anemia occurs, it should raise suspicion. Although anemia can be caused by many factors, raising suspicion in advance is the best means of prevention.