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Multiple myeloma

Myeloma multiplex · Mnohočetný myelom

What it is

Malignant plasma cells eat bone and clog the kidneys with light chains.

Symptoms & signs

  • Bone pain, especially the back
  • fractures
  • fatigue from anaemia
  • kidney impairment
  • high calcium
  • recurrent infection

🚩 Get help if…

  • call 112 / 911 now New back pain with leg weakness, numbness or loss of bladder control
  • call 112 / 911 now Fever over 38 °C during treatment
  • see a doctor soon Great thirst, confusion or constipation
  • see a doctor soon Passing much less urine

Where it strikes

Medical treatment

  • Quadruplet induction (daratumumab-VRd) — its lenalidomide is a relative of thalidomide, which deformed about 10 000 babies in 1957–62, so pregnancy must be excluded
  • autologous stem-cell transplant
  • bisphosphonates
  • radiotherapy for lesions
  • dialysis if needed
  • CAR-T (ciltacabtagene, idecabtagene) — approved 2021–22 for relapsed myeloma
  • bispecifics (teclistamab, talquetamab) — approved 2022–23 for relapsed myeloma; infections are the main harm

Natural & lifestyle

  • Hydration to protect kidneys
  • weight-bearing exercise as safe
  • calcium and vitamin D per advice
  • infection precautions

Emerging & experimental

  • MRD-adapted therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Curcumin in smouldering myeloma — small studies early / small studies
  • Green tea with bortezomib — it blocks the drug in the laboratory; avoid during treatment not confirmed in trials

ICD codes