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A treatable plasma cell cancer where response depth increasingly guides care
Multiple myeloma is a malignancy of clonal plasma cells that causes bone disease, anaemia, renal impairment, hypercalcaemia and immune suppression. Diagnosis requires clonal plasma cells plus myeloma-defining events. Treatment combines proteasome inhibitors, immunomodulatory drugs, steroids, antibodies and, for eligible patients, autologous transplant. MRD assessment is increasingly used.
Haematology & Haemato-Oncology
Authored and reviewed by Dr. Sachita Baniya (MBBS, FCPS (Clinical Haematology), NMC 20158). Evidence-based, no fabricated outcomes.
Multiple myeloma is a malignancy of clonal plasma cells that causes bone disease, anaemia, renal impairment, hypercalcaemia and immune suppression. Diagnosis requires clonal plasma cells plus myeloma-defining events. Treatment combines proteasome inhibitors, immunomodulatory drugs, steroids, antibodies and, for eligible patients, autologous transplant. MRD assessment is increasingly used.
Reviewed by Dr. Sachita Baniya, MBBS, FCPS — Consultant Haemato-Oncologist & Clinical Hematologist (NMC 20158). For evaluation, contact the respective hospital or cancer centre — Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital Kathmandu, or Advanced Care Hospital.
Diagnosis requires serum and urine protein electrophoresis, immunofixation, serum free light chains, bone marrow plasma cell assessment, FISH risk stratification and imaging. The CRAB criteria and specific biomarkers define active disease. Baseline renal function, calcium, blood counts and infection status are needed before treatment.
Initial therapy is risk-adapted and often combines a proteasome inhibitor, an immunomodulatory drug, a steroid and an anti-CD38 antibody. Eligible patients may proceed to autologous transplant, with maintenance afterwards. Response is assessed by protein studies and MRD where available. Supportive care includes bone protection, infection prevention, thrombosis prophylaxis and renal monitoring.
Guidelines referenced:
International Myeloma Working Group diagnostic criteriaNCCN Guidelines — Multiple MyelomaESMO Clinical Practice Guidelines — Multiple MyelomaContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.