Risk Factors, Complications, And Treatment Options For Multiple Myeloma

Bone Pain And Thinning Bones

Bone pain and thinning bones are both symptoms and complications that occur as a result of multiple myeloma. Healthy individuals have bones that are constantly going through a process of bone breakdown and rebuilding. In order for the bones to stay strong, healthy, and functional, the patient's body has to be able to keep a balance between both of those processes. Osteoclasts are cells responsible for breaking down old bone, while osteoblasts are cells responsible for laying the matrix to form new bone. Multiple myeloma patients develop a negative imbalance of this process in the body. The cancerous myeloma cells produce a compound that signals their osteoclasts to break down old bone faster than usual. This malfunction means old bone is dissolved before the osteoblasts are able to replace it. This process causes bone pain and weakness in affected individuals that often progresses to multiple bone breaks or fractures. In addition, the process of bone breakdown that is in overdrive in an affected individual can cause their blood calcium levels to become too high.

Issues With Kidney Function

A common complication that occurs in individuals affected by multiple myeloma are issues with kidney function. Out of all patients diagnosed with the disease, between twenty and forty percent of them have a degree of kidney failure at their time of diagnosis. Multiple myeloma cells are known to produce abnormal proteins that tend to build up in the patient's bloodstream. Kidneys have a very critical component called glomeruli, which are many tiny filters the blood passes through for filtration. When the blood flows through the glomeruli, it then passes into the pipes or tubules in the kidney. The abnormal proteins in the blood are able to pass through the filters, but a problem occurs when the proteins enter the tubules. A protein in the tubules called Tamm Horsfall protein inappropriately binds with the abnormal proteins. Once linked, the combination of proteins become too large to pass through the tubules and leave the kidney through the urine. This malfunction causes the tubules to become blocked with these bound proteins. Blocked tubules do not allow the passage of fluid, causing damage to the kidney and its function. This damage results in an inflammatory response by the individual's immune system that exasperates the decreased kidney function.