This booklet provides information about myeloma for patients and their families. A brief description of normal blood and marrow is provided for background, followed by a detailed description of myeloma and its treatment. The booklet includes a glossary to help readers understand medical terms.
Bone pain is the most common early symptom of myeloma. Most patients feel pain in their back or ribs, but it can occur in any bone. The pain is usually constant and made worse by movement. Normally, bone is remodeled continuously in the body. This remodeling is a coordinated effect of cells that dissolve bone (osteoclasts) and cells that lay down new bone (osteoblasts). Bone pain and destruction can be a part of myeloma because myeloma cells secrete a type of chemical called a "cytokine," which stimulates the cells that dissolve bone and inhibits cells that form bone. In other words, the chemicals secreted by myeloma cells stimulate the bone-dissolving cells into overactivity and inhibit the bone-forming cells, resulting in unopposed bone destruction. As a result of this imbalance in the normal bone remodeling process, holes (lytic lesions) develop in the bone. Bone is thinned (osteoporosis) and can be weakened enough to fracture during everyday activities such as walking, lifting or sneezing.