Multiple Myeloma

Symptoms

The symptoms of multiple myeloma can vary from person to person, but a common symptom is fatigue. When myeloma cells replace oxygen-carrying red blood cells in the bone marrow, anemia can result, causing tiredness or fatigue.

Another symptom of multiple myeloma is pain in the back, ribs, or other bones, which may be caused by the large number of myeloma cells in bone marrow. The pain, which can be severe, may occur months before a diagnosis is made. Unexplained bone fractures may also be a sign of myeloma.

Myeloma can cause the bones to become thin and weak (osteoporosis). X-rays of the bones sometimes appear to show holes called "lytic lesions." These are not actually holes, but are weakened areas of bone associated with concentrations of myeloma cells.

Sometimes calcium from affected bones may dissolve into the blood, creating a high blood-calcium level. High blood calcium can cause sleepiness, fatigue, constipation, loss of appetite, and excessive thirst and urination.

Myeloma cells also may produce an unusual amount of monoclonal (M) protein. This protein may be called Bence Jones protein when it is found in the urine or an M-spike when found in the blood. Whether this protein is found in the blood or the urine (or both) varies from person to person. Some people with myeloma produce no M protein, in which case the myeloma is called "non-secretory." Occasionally, monoclonal protein may deposit in the kidneys. These deposits can damage the kidneys and prevent normal filtering of the blood's waste products. While symptoms are not always present, unusual amounts of M protein may cause fatigue, nausea and anemia.