Giovanni Allevi stated on social media that he suffers from myeloma, a particularly insidious disease. It can manifest with many symptoms and signs, so much so that it can sometimes begin with a bone-breaking pain or severe back pain. In some people, therefore, unexplained fractures, kidney problems, infections appear. In short, drawing a precise identikit of myeloma is difficult.
However, we know that this blood cancer it affects plasma cells, white blood cells in the bone marrow that help fight infections. When plasma cells escape the control of the body and multiply too quickly they can give rise to myeloma, and by accumulating they can create real lesions. The health problems caused by multiple myeloma can involve the bones, immune system, kidneys and blood cells. There treatment it must always be studied case by case, with the possibility of intervening at different levels of severity of the pathology with specific treatments, as the AIL experts recall on the site of the same name.
What happens in the blood cells
Multiple myeloma is a form of cancer that originates in the bone marrow, the “production center” of blood cells. In particular, in this case a single progenitor cell of ours immune systema white blood cell called B lymphocyte, undergoes agenetic alteration and acquires tumor characteristics which will be transmitted to all the cells that descend from it, called plasma cells. These normally do not represent more than 1% of the total units present in the bone marrow. To understand when and how one can suspect one pathology of this type, it is necessary to try to “visualize” what happens in terms of blood tests and visualization of the increase in plasma cells in tests.
One can take the example of the “horns” of cattle, which are on the sides of the head. In fact, this particular image can be repeated even when diagnosing myeloma: the increase in plasma cells is almost always responsible for the presence in the blood and / or urine of a high quantity of immunoglobulins or their fragments. Unfortunately, however, these immunoglobulins are characterized by the presence of a real “peak” in a certain region, which leads to a classic profile with a “specific” increase in immunoglobulins which is defined as a monoclonal component.
Obviously a monoclonal peak in the protein trace does not automatically translate into the presence of myeloma. This must always be remembered and for this reason it must be the doctor who judges the situation and possibly proposes specific exams since in many cases, fortunately, the increase in the monoclonal component in the blood is still reduced. In any case, in multiple myeloma, typically the majority of the medullary elements are constituted by tumor plasma cells. There overabundance of tumor plasma cells in the bone marrow it causes increased production of proteins that suppress the development of other normal marrow elements, such as white blood cells, red blood cells and platelets (cell-like particles that are involved in the blood clotting process in the body). In addition to producing large amounts of monoclonal antibody, the production of normal defensive antibodies it is remarkably reduced.
How many people does it affect
Multiple myeloma is a malignant blood tumor in which plasma cells proliferate uncontrollably and accumulate in the bone marrow or, more rarely, in tissues outside the bone marrow. It is a tumor that is responsible for 1-2% of all neoplasms and 10-15% of hematological cancers. According to the 2020 edition of “Cancer numbers in Italy” published in 2020 by the Italian Cancer Registries Association (AIRTUM) in collaboration with the Italian Association of Medical Oncology (AIOM) and others, reported that in our country approximately 5700 new cases of multiple myeloma are estimated each year, with an incidence of 3019 cases in men and 2740 in women. As mentioned, the clinical picture it can vary greatly from person to person.
There are patients with multiple myeloma altogether asymptomatic, especially in the early stages of the disease. But most people who develop the disease have signs and symptoms that make them suspect. First, the massive proliferation of plasma cells causes a reduction in normal immune function and, therefore, a reduction in immunoglobulin levels and an increase in risk of infections.
Often there are pictures related to the insufficiency of bone marrow activity, with consequent anemia, responsible for tiredness, weakness, breathing difficultiesand / or, more rarely, a reduction in white blood cells (leukopenia) or platelets (thrombocytopenia), resulting in less resistance to infections and ease of bleeding, even after trivial cuts. The bone lesions characteristic of multiple myeloma can also induce pain, a very common symptom. It is mainly localized in the back, hip and side, and can lead to greater bone fragility. Finally, theincreased calcium in the blood it can favor the appearance of symptoms affecting the nervous system and kidneys.