Myeloma is a cancer of the plasma cells (a type of white cell). Plasma cells are found primarily in the marrow. About 90 percent of people with myeloma have disease involving multiple sites at the time of diagnosis. Some individuals have myeloma that progresses very slowly
(often referred to as “smoldering” or “indolent” myeloma).
In myeloma, a B lymphocyte (the cell-type that forms plasma cells) becomes malignant. Eventually, malignant plasma cells (myeloma cells) amass in the marrow and sometimes other sites in the body. The myeloma cells disrupt normal blood production, destroy normal bone tissue and cause pain. Healthy plasma cells produce immunoglobulins (antibodies) that protect the body against certain types of infection. The onset of myeloma interferes with antibody production, making people with myeloma susceptible to infection and other serious complications.
Living with Myeloma
An estimated 66,529 people in the United States were living with, or in remission from, myeloma.
New Cases
An estimated 20,580 new cases of myeloma (11,680 men and 8,900 women) are expected to be diagnosed in the United States in 2009.
Incidence
Gender. The incidence rate for the years 2002 to 2006 was 54 percent higher in men (7.1 per 100,000) than in women (4.6 per 100,000).
Race and Ethnicity. From 2002 to 2006, myeloma was the 10th most commonly diagnosed cancer among black men and women.
• The median age at diagnosis for blacks is 66.
• Blacks have more than double the incidence rate (11.7 per 100,000) of myeloma than whites (5.2 per 100,000).
• Black men who are 45 years and older have higher myeloma incidence rates than black women and white men and women.
• The highest incidence rates are found in black men 80 to 84 years of age (93.6 per 100,000).
Signs and Symptoms
The first symptom of myeloma is often bone pain from the effects of myeloma cells on the marrow. Fractures may occur as a result of the weakened bones. Anemia, recurrent infections or numbness or pain in the hands and/or feet (caused by a condition called “peripheral neuropathy”) can also be early signs of the disease. People with myeloma may have no symptoms or they may tire more easily and feel weak.
Possible Causes
The cause of myeloma is unknown in most cases. Long-term exposure to certain chemicals seems to increase risk for developing myeloma, but most people who have myeloma do not have any history of such exposure, indicating that other factors must play major roles.
Treatment
The goals of treatment for people with myeloma are to reduce symptoms, to slow disease progression and to provide prolonged remissions. There have been significant treatment advances in recent years. The approach for treating each person is customized, based on the extent of disease and the rate of disease progression. People who have a slow-growing myeloma and no symptoms, may not
need treatment immediately. Some people need only supportive care to reduce symptoms of anemia, high blood calcium levels, infections and/or bone damage or osteoporosis. Patients who require myeloma-specific therapies may receive combination drug therapy, high-dose chemotherapy with stem cell transplant (autologous, allogeneic or reduced-intensity allogeneic), radiation therapy for local disease and/or new and emerging drug therapies as part of clinical trials.
Survival
Current statistical databases show that overall, five-year relative survival in people with myeloma has improved significantly since the 1960s.
• Five-year relative survival has increased from 12 percent in 1960-1963 (for whites) to 37.1 percent from 1999 to 2005 (for all races and ethnicities).
• Five-year survival for white males (40.1 percent) increased the most.
• The three-year survival rate as of January 1, 2006 was nearly 56 percent.
Deaths
Approximately 10,580 deaths from myeloma are anticipated this year.
Gender. Myeloma was the seventh most common cause of cancer death for black women and the twelfth most common cause of cancer death for white women from the years 2002 to 2006.
Race and Ethnicity. In 2009, approximately 3 percent of all cancer-related deaths among blacks is expected to be from myeloma.
• The mortality rate for myeloma from 2001 to 2005 for black men was nearly double the rate for white men (8.3 per 100,000 vs. 4.3 per 100,000). For black women, it was more than twice the rate for white women (6.0 per 100,000 to 2.8 per 100,000).
• The US median age at death from myeloma is 74 years. It is between 70 and 71 years for blacks and is 70 years for Hispanics.
This information has been provided by the Leukemia and Lymphoma Society.
