Causes and Risk Factors of Multiple Myeloma (2022)

Multiple myeloma (sometimes referred to as myeloma) is a rare type of blood cancer that involves the abnormal growth of plasma cells—a type of white blood cell—that accumulate uncontrollably in the bone marrow.The immune system is impacted due to the inefficiency of the plasma cells to produce healthy antibodies, which fight infection.The overgrowth of plasma cells crowds other blood cells, reducing the number of healthy red and white blood cells.

This often results in conditions such as frequent infections, anemia, low platelet count (blood clotting cell count), and more.The myeloma cells can also result in painful bone tumors and destruction of bone tissue that leads to a high risk of bones that are easily fractured. In the late stage of the disease, the organs may be affected due to myeloma cells producing abnormal antibodies—called M proteins—that build up in the body, causing damage to the kidneys.

Causes and Risk Factors of Multiple Myeloma (1)

Common Causes

The exact cause of multiple myeloma is unknown.However, what researchers do know about multiple myeloma is the fact that the condition starts with the abnormal growth of a plasma cell in the bone marrow.Next, the abnormal cell begins to multiply rapidly.

The symptoms occur due to the abnormal duplication of the plasma cells in the bone marrow, but no one knows exactly what causes the plasma cells to begin this abnormal growth pattern.

Research scientists hypothesize that there are probably several causes that contribute.

Genetic Abnormalities

These are changes or mistakes in the DNA.The DNA contains the code of instructions that tell each cell how to perform, grow, divide, and when to stop multiplying.These mistakes are called “mutations” and they may cause plasma cells to become cancerous.The DNA is packaged into chromosomes in the cells.

According to theAmerican Cancer Society, “Myeloma cells also show abnormalities in their chromosomes...In about half of all people with myeloma, part of one chromosome has switched with part of another chromosome in the myeloma cells.” When this occurs in an area next to a gene that is responsible for how the plasma cell grows and divides, it can result in cancerous plasma cells.

(Video) Multiple Myeloma - signs and symptoms, pathophysiology, treatment

Bone Marrow Abnormalities

Some of the bone marrow abnormalities involve dendritic cells—they may cause plasma cells to grow and develop abnormally, which may contribute to plasma cell tumors.

Environmental Factors

Environmental factors, such as exposure to certain chemicals or radiation, have been implicated as a contributing factor in the cause of multiple myeloma.

It’s important to note that most people who are diagnosed with multiple myeloma and who are screened for risk factors end up having no known risk factors other than age.

Genetics

Although it is known that cancer is caused by changes called “genetic mutations” to the DNA inside of the cells, the underlying reason these changes occur is not completely clear to researchers.

Most cancers, including multiple myeloma, are thought to occur due to mutations of genes that occur after birth, influenced by factors such as carcinogens (cancer-causing chemicals).The body has a normal way of fixing mistakes that occur when a cell grows and gene mutations occur, however, occasionally, the mistake is overlooked—this could cause the cell to become cancerous.

Another common genetic mistake that is very common in those with myeloma is a missing piece of chromosome 13, or the entire chromosome missing in many cases. In fact, one study involving 1,500 multiple myeloma patients wasreportedby the American Society of Clinical Oncology (ASCO).According to the lead study author, Guido J.Tricot, MD, PhD., "Chromosomal studies are the most important prognostic factor in the treatment of myeloma."

He went on to say that "Chromosome 13 deletion and hypodiploidy [having slightly less than the normal number of chromosomes] is associated with poor prognosis, but too many institutes are failing to do these studies which can predict outcome and help customize treatment."

Approximately 42 percent of the people diagnosed with multiple myeloma have a deletion of chromosome 13.

(Video) Multiple Myeloma - Diagnosis, Symptoms, and Treatment

Although it is not clearly understood why the chromosome deletion occurs in those with myeloma, these patients are known to have a marked reduction in survival rates.They also have a higher incidence of resistance to traditional myeloma treatment regimes.

Lifestyle Risk Factors

A risk factor is something that can increase the chance of someone getting a disease, such as cancer.Each type of cancer has its own risk factors. For example, smoking causes an increased risk of getting lung cancer, and prolonged exposure to the sun proposes an increased risk of skin cancer.

However, risk factors do not necessarily indicate that a person will get a specific type of cancer.People with no risk factors at all often get a disease, including cancer. Those having one (or even several) risk factors may never get a disease.Generally, there are two types of risk factors, including non-modifiable and modifiable risk factors.

Non-Modifiable Risk Factors

Non-modifiable risk factors are those that cannot be changed. For multiple myeloma, these include a number of factors.

  • Age. Most commonly, the disease occurs in those over 60 years old, and only a small percentage (1 percent) of the those who have been diagnosed are under 35.The average age to be diagnosed with myeloma is 65.
  • Sex. Men are slightly more prone to getting multiple myeloma than women.
  • Race. Myeloma is said to be more prevalent in the Middle East, North Africa, and the Mediterranean region.Although the underlying reason is unknown, the prevalence of the disease occurs twice as often in African Americans than in Caucasians.
  • Family history. Although some sources report a strong familial link to myeloma, a 2018 report by theAmerican Society of Clinical Oncology (ASCO)stated, "There appears to be a slight increase in the incidence ofthe disease in first-degree relatives (parents or siblings) of people with multiple myeloma.”

However, the ASCO also stated that "Mutations or changes in plasma cells are acquired, not inherited, so having a relative with the disease usually does not mean another family member is at higher risk for developing it."

Modifiable Risk Factors

Modifiable risk factors are those that can be changed.These usually include lifestyle factors, such as diet and exercise. For multiple myeloma, however, the primary modifiable risk factors involve exposure to environmental substances (usually related to a person’s occupation).

Exposure to Chemicals or Radiation

Exposure to chemicals such asthoseinasbestos and pesticides, as well as exposure to benzene—a substance present in rubber manufacturing—may pose an increased risk of developing myeloma.Exposure to certain types of plastics, heavy metal dust, hair dyes, herbicides (including Agent Orange), and pesticides may also increase the risk of getting myeloma.

Radiation exposure has been found to have a very strong link to myeloma as well. For example, those who were exposed to radiation from the atom bomb, during World War II (in Nagasaki and Hiroshima) were found to have a significantly higher incidence of multiple myeloma compared to the general population.

Occupational Exposure

(Video) What Causes Smoldering Myeloma and Who is at High Risk?

This is linked to the exposure to specific chemicals and includes people working in the leather, cosmetology, rubber, and petroleum fields. Other occupational types of exposure that may increase the risk of myeloma include working with wood products (those who make furniture, paper makers, or carpenters).Farmers and professional firefighters are also thought to have an increased risk of getting myeloma.

Obesity or Being Overweight

Obesity or being overweight is also linked with a higher risk of most types of cancer—this includes multiple myeloma. Both obesity and being overweight are considered modifiable risk factors for multiple myeloma that directly pertain to a person's lifestyle.

Other Risk Factors

Personal Health History

Those who have had prior plasma cell conditions (such as plasmacytoma of the bone or monoclonal gammopathy) are at greater risk of developing myeloma than those who have not had these conditions.

Monoclonal Gammopathy (MGUS)

Just about every case of myeloma begins as whatMayo Clinicdescribes as “a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS).”Mayo Clinic goes on to explain that “In the United States, about 3 percent of people older than age 50 have MGUS. Each year, about 1 percent of people with MGUS develop multiple myeloma, or a related cancer.”

The cause of MGUS is unknown. It is a condition that involves the presence of M protein, like myeloma, but the level of M protein is lower in MGUS. Also, there is not any damage to the body in MGUS (such as organ or bone damage).

A Word FromVerywell

We realize that for those who are diagnosed with multiple myeloma, not knowing the exact cause of an illness—particularly one that is as severe as myeloma—can be very frustrating.Although experts are unsure of the exact cause of cancer, medical research continues to reveal new and more effective treatment modalities that are aimed at improving the survival rates. As the incidence of myeloma continues to rise, so do the efforts to find a cure. More efforts are aimed at slowing down the progression of the disease, which would give patients more years of symptom-free life.

Frequently Asked Questions

  • What are the signs and symptoms of multiple myeloma?

    (Video) Multiple Myeloma: Risk Factors, Treatment Options, Searching for a Cure | Mass General Brigham

    Some patients with multiple myeloma won't have any symptoms. When signs and symptoms do occur, they may include:

    • Bone pain or fractures
    • Anemia
    • Increased infections
    • Abnormal bleeding
    • Increased calcium in the blood, or hypercalcemia
    • Spinal cord compression
    • Nerve damage, or peripheral neuropathy
    • Kidney damage
  • Is multiple myeloma an inherited condition?

    It's not usually considered an inherited condition, but family history may be a risk factor. Multiple myeloma is caused by changes or mutations that are acquired rather than inherited. First-degree relatives of people with the disease seem to be two or four times as likely to get it, but the overall risk is still small at about 2% to 3%.

How Is Multiple Myeloma Diagnosed?

FAQs

What are risk factors for multiple myeloma? ›

There are several risk factors for multiple myeloma, including age, sex, obesity, radiation exposure, and race. Having other plasma cell conditions can also increase the risk of multiple myeloma, especially MGUS. Almost all multiple myeloma patients have previously had MGUS. Multiple myeloma cannot be prevented.

What race is most at risk for multiple myeloma? ›

Race. Multiple myeloma is more than twice as common in African Americans than in white Americans.

What is the most common cause of death in multiple myeloma? ›

The most common cause of death was infection (42,33%) followed by progession (39,26%). We could compare data of these patients with those without EM from 1990 to 2009 (n=255) and we found that patients with EM were older (p=0,039), with more comorbidities (p=0,004) and worse ECOG (p<0,001).

Why is obesity a risk factor for multiple myeloma? ›

Obesity and myeloma share signaling pathways that upregulate insulin, IGF-1, leptin, and inflammatory cytokines, raising the risk of malignant transformation [57, 58].

What cleaning products cause multiple myeloma? ›

Researchers have found that myeloma is more likely in people who come into contact with chlorinated solvents such as:
  • 1,1,1-trichloroethane (TCA)
  • Trichloroethylene (TCE)
  • Methylene chloride (DCM)
  • Perchloroethylene (PCE)
22 Dec 2021

What viruses can cause myeloma? ›

Human herpesvirus-8

Human herpesvirus-8
The HHV-8 or KSHV is a double-stranded DNA virus subclassified as gammaherpesviruses. The gammaherpesviruses are a lymphotropic virus that undergoes lytic replication in epithelial cells such as skin, blood vessels, and organs. These viruses can establish latency in their host cells for a lifetime.
https://www.ncbi.nlm.nih.gov › books › NBK556023
has been strongly implicated in the pathogenesis of KS, BCBL, and multicentric Castleman's disease. Evidence for its role in the pathogenesis of multiple myeloma is accumulating. Human herpesvirus-8 is detectable in the nonmalignant bone marrow dendritic cells from most myeloma patients.

Does stress cause multiple myeloma? ›

Stress can be a very destructive force when it comes to myeloma. Stress really disrupts the immune system and myeloma is a cancer of the immune system. In addition, the stress hormone noradrenaline (the "flight" hormone, versus adrenaline, the "fight" hormone) can actually trigger cancer cell growth directly.

Can drugs cause multiple myeloma? ›

An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0).

How did I get multiple myeloma? ›

What Are Its Causes? Exposure to toxic chemicals, atomic radiation, anything that interferes with the immune system, or infection with cancer-causing viruses have all been implicated as causes or triggers of myeloma. Toxic chemicals that have been identified include: benzene.

What is the most common complication of multiple myeloma? ›

Complications of multiple myeloma include:
  • Frequent infections. Myeloma cells inhibit your body's ability to fight infections.
  • Bone problems. Multiple myeloma can also affect your bones, leading to bone pain, thinning bones and broken bones.
  • Reduced kidney function. ...
  • Low red blood cell count (anemia).
16 Jun 2021

What infections are common in multiple myeloma? ›

The most common infections were meningitis, septicemia, pneumonia, osteomyelitis, cellulitis, and pyelonephritis. The risk of viral infections was 10-fold higher overall and 18-fold during the first year.

Does multiple myeloma cause leg pain? ›

Nerve damage: Myeloma proteins can be toxic to your nerves. This can lead to a condition called peripheral neuropathy that causes a pins-and-needles feeling, often in your legs and feet.

Can multiple myeloma cause weight gain? ›

People undergoing treatment for multiple myeloma are more likely to gain weight. People with myeloma may sometimes gain weight and at other times lose weight, depending on the stage of their illness and their treatment.

Does MGUS cause weight gain? ›

Obesity is not associated with MGUS or LC-MGUS. High body mass index during midlife is associated with increased risk of progressing from MGUS and LC-MGUS to MM and other LP diseases.

Does MGUS have symptoms? ›

Symptoms. People with monoclonal gammopathy generally don't experience signs or symptoms. Some people may experience a rash or nerve problems, such as numbness or tingling. MGUS is usually detected by chance when you have a blood test for another condition.

How can you prevent multiple myeloma? ›

With multiple myeloma, few cases are linked to risk factors that can be avoided, so there is no known way to prevent most multiple myelomas from developing.

Does alcohol affect multiple myeloma? ›

The present meta-analysis of published data found no strong association between alcohol drinking and MM risk, although a modest favorable effect emerged for moderate-to-heavy alcohol drinkers.

Can toxic water cause multiple myeloma? ›

However, most Veterans do not know all of the disabilities for that may arise due to exposure to the contaminated water. One of the most prevalent illnesses for Veterans who were exposed to the contaminated water is multiple myeloma.

What are the early warning signs of multiple myeloma? ›

Symptoms of multiple myeloma
  • Pain in the bones of the back or ribs.
  • Bones that fracture easily.
  • Fatigue and weakness.
  • Shortness of breath.
  • Dizziness.
  • Unexplained weight loss.
  • Frequent infections and fevers.
  • Frequent need to urinate and extreme thirst.
24 Jun 2022

Can myeloma cause other cancers? ›

Survivors of multiple myeloma can get any type of second cancer, but they have an increased risk of: Acute myeloid leukemia (AML) Myelodysplastic syndrome (MDS)

What blood tests indicate multiple myeloma? ›

Tests to Find Multiple Myeloma
  • Blood counts. The complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in the blood. ...
  • Blood chemistry tests. ...
  • Urine tests. ...
  • Quantitative immunoglobulins. ...
  • Electrophoresis. ...
  • Serum free light chains. ...
  • Beta-2 microglobulin. ...
  • Bone marrow biopsy.
28 Feb 2018

Can you live a normal life with myeloma? ›

Apart from ongoing monitoring, most myeloma patients are able to live fairly normal lives, with few restrictions on low-impact exercise and other activity.

Does myeloma affect the brain? ›

What is it? Myeloma and myeloma treatments can affect the brain's ability to collect, retain and process information. 'Chemo brain' is a term used to describe the mind and memory issues cancer patients can experience. Your healthcare team may refer to these symptoms as cancer-related cognitive changes.

Does myeloma cause itching? ›

Multiple myeloma is a type of cancer that happens when lymphocytes (white blood cells) called plasma B cells begin to grow quickly and uncontrollably. Treatments for multiple myeloma can cause many skin-related symptoms, including rashes, blisters, and itchy skin.

What is the best treatment for multiple myeloma? ›

Steroids. Corticosteroids help destroy myeloma cells and make chemotherapy more effective. The most common types used to treat myeloma are dexamethasone and prednisolone.

What is the new treatment for multiple myeloma? ›

Selinexor(Xpovio) is a newer type of multiple myeloma drug called a selective inhibitor of nuclear export (SINE). It works by blocking XPO1, a protein that allows cancer cells to thrive. The FDA approved selinexor for treatment of relapsed or refractory disease.

Which medicine is best for multiple myeloma? ›

The drugs used most often for treating bone problems in people with myeloma are the bisphosphonates pamidronate (Aredia) and zoledronic acid (Zometa) and the drug denosumab (Xgeva, Prolia). These drugs are given intravenously (IV or into a vein) or subcutaneously (under the skin).

How long can you have myeloma without knowing? ›

Some people have multiple myeloma for months or years before they even know they're sick. This earliest phase is called smoldering multiple myeloma. When you have it, you won't have any symptoms, but your test results will show: At least 10% to 59% of your bone marrow is made up of cancerous plasma cells.

Is myeloma serious? ›

Myeloma is not usually considered a curable disease, but it is very treatable. Myeloma is a disease that shifts between periods of remission (when cancer cells are no longer detected or are at a low level) and relapse (when cancer cells have returned or increased).

Can multiple myeloma spread? ›

Unlike many cancers, multiple myeloma appears to spread via the bloodstream. It can reach different parts of the body quickly, making it hard to treat. Multiple myeloma is a type of plasma cell neoplasm. Other examples include monoclonal gammopathy of undetermined significance (MGUS) and plasmacytoma.

Can multiple myeloma spread to heart? ›

Heart and Lung Problems. Multiple myeloma puts you at risk for heart and lung problems, including blood clots, pulmonary hypertension, heart failure, and irregular heartbeat (arrhythmias) among other problems.

Why is it called multiple myeloma? ›

Myeloma causes structural bone damage, which can result in weakened bones and leads to painful fractures or bone breaks over time. Myeloma is usually called multiple myeloma because most people (90% or more) have more than 1 bone lesion when they are diagnosed or lesions develop over the course of the illness.

How does myeloma affect the lungs? ›

The intraparenchymal causes of respiratory failure from multiple myeloma include alveolar septal amyloidosis, plasma cell infiltration of lung parenchyma, accumulation of alveolar paraproteins, and metastatic calcification of the alveolar walls and blood vessels.

Does multiple myeloma affect your breathing? ›

Shortness of breath, also called dyspnea, is a common symptom of multiple myeloma, a type of cancer that forms in blood cells. Feeling like you can't catch your breath — or, in severe cases, feeling like you can't breathe at all — can be extremely worrying.

Are UTI's common in multiple myeloma? ›

The most common infections seen were pneumonia (24%), bacteremia (20%), urinary tract infection (UTI, 20%), central venous catheter infections (7%) and Clostridium difficile infection (3.4%).

Why does multiple myeloma cause infection? ›

But when you have myeloma, those cells don't act the way they should. Instead of making antibodies to fight infections, they make other abnormal proteins. They also build up in your bones and crowd out other cells your body needs. Because of this, frequent infections are a common symptom of multiple myeloma.

What bones hurt multiple myeloma? ›

Bone pain. Multiple myeloma can cause pain in affected bones – usually the back, ribs or hips. The pain is frequently a persistent dull ache, which may be made worse by movement.

Can myeloma affect your knees? ›

Multiple myeloma can occasionally manifest with joint disease. We report the case of an individual with a progressive bilateral carpal syndrome and a symmetrical severe seronegative polyarthritis and joint swelling.

How does myeloma pain feel? ›

Up to 70 out of every 100 people (70%) have pain when they are diagnosed with myeloma. People mostly describe the pain as dull or aching, and it is often felt in the lower back or ribs.It might feel like there is pain in your muscles too. Pain in the bones is caused by a lot of plasma cells collecting there.

Does stress cause multiple myeloma? ›

Stress can be a very destructive force when it comes to myeloma. Stress really disrupts the immune system and myeloma is a cancer of the immune system. In addition, the stress hormone noradrenaline (the "flight" hormone, versus adrenaline, the "fight" hormone) can actually trigger cancer cell growth directly.

Is alcohol a risk factor for multiple myeloma? ›

The present meta-analysis of published data found no strong association between alcohol drinking and MM risk, although a modest favorable effect emerged for moderate-to-heavy alcohol drinkers.

What foods should I avoid with multiple myeloma? ›

Since medications used to treat multiple myeloma often cause nausea and vomiting, avoid foods that are spicy and fried. Avoid foods with strong odors. Instead, choose foods that are at room temperature and bland such as crackers, cheese, canned fruit, yogurt, toast, potatoes, rice, and pasta. Choose protein-rich foods.

What is the life expectancy of multiple myeloma? ›

83.1% of males survive myeloma for at least one year. This falls to 52.6% surviving for five years or more, as shown by age-standardised net survival for patients diagnosed with myeloma during 2013-2017 in England. [1] Survival for females at one year is 82.1% and falls to 51.8% surviving for at least five years.

How can you prevent multiple myeloma? ›

There are currently no known ways to prevent it. Currently, there are also no obvious, strong risk factors for myeloma. Although the mutations that cause myeloma are acquired and not inherited, family history is a known risk factor for multiple myeloma.

Can you live a normal life with myeloma? ›

Apart from ongoing monitoring, most myeloma patients are able to live fairly normal lives, with few restrictions on low-impact exercise and other activity.

What is usually the first early symptom of multiple myeloma? ›

Multiple myeloma causes many symptoms, but bone pain often is the first symptom people notice. Other symptoms include: Weakness in your arms and legs and/or a sensation of numbness in your arms and legs. Multiple myeloma can affect the bones in your spine, causing them to collapse and press on your spinal cord.

Can I drink wine with multiple myeloma? ›

Recent findings have suggested that consuming at least some alcohol may reduce the risk of myeloma.

Is multiple myeloma caused by smoking? ›

We found no significant association between smoking status, number of cigarettes smoked, or duration of smoking and the risk of developing leukemias, lymphomas, or multiple myeloma.

Is beer good for multiple myeloma? ›

One 2013 study found that consuming alcohol may be associated with a lower risk of multiple myeloma. One possible reason alcohol might have this effect is because small to moderate consumption helps reduce factors that can prompt inflammation, according to the International Myeloma Foundation.

Is banana good for multiple myeloma? ›

Foods to avoid with kidney damage

As kidney function declines, people with multiple myeloma may need to limit their intake of potassium, phosphorus, and fluids. Foods that are high in potassium include: avocados. bananas.

Are eggs good for multiple myeloma? ›

Since multiple myeloma makes your immune system weaker, you'll need to steer clear of any foods that could make you sick, including: Raw meat or fish. Runny eggs. Unpasteurized drinks.

Is coffee good for multiple myeloma? ›

Conclusions: In this study, we observed no significant association between coffee or green tea consumption and the risk of malignant lymphoma or multiple myeloma.

What is the best treatment for multiple myeloma? ›

Steroids. Corticosteroids help destroy myeloma cells and make chemotherapy more effective. The most common types used to treat myeloma are dexamethasone and prednisolone.

Does multiple myeloma affect memory? ›

Mind and memory problems are common in myeloma and can be extremely frustrating. Our team of Myeloma Information Specialists often get calls and emails from patients who are experiencing problems such as mental fogginess and difficulty remembering words.

How does multiple myeloma cause death? ›

Infection is a major complication and a leading cause of death in patients with multiple myeloma (MM) [1]. The risk of infection is due to a multifactorial immunodeficiency caused by the disease itself and the treatment regimens given during the different phases of therapy [2].

Videos

1. Signs, symptoms and treatment for multiple myeloma - Mayo Clinic
(Mayo Clinic)
2. Signs and Symptoms of Multiple Myeloma
(Roswell Park Comprehensive Cancer Center)
3. What is the Best Treatment for Multiple Myeloma?
(Roswell Park Comprehensive Cancer Center)
4. ASK UNMC! What are the symptoms of multiple myeloma?
(UNMCEDU)
5. Multiple myeloma treatment at Mayo Clinic
(Mayo Clinic)
6. Treatment Options for Multiple Myeloma - Mayo Clinic
(Mayo Clinic)

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