This disease attacks the men and women, and are commonly found in over 40 years. Plasma cell tumors (plasmasitoma) most commonly found in the pelvis, spine, ribs and skull. Sometimes they are found in areas other than bone, especially in the lungs and reproductive organs. Abnormal plasma cells almost always produce large amounts of abnormal antibodies and antibody formation are normally reduced. As a result, patients are more susceptible to infection.

Fraction of abnormal antibodies are often collected in the kidney, causing damage and sometimes cause kidney failure. Deposition of antibody fragments in the kidneys or other organs can cause amyloidosis. Fractions of abnormal antibodies in the urine called Bence-Jones protein.

CAUSE
It is not known.

SYMPTOMS
Multiple myeloma often causes bone pain (especially in the spine or ribs) and the bone so easily broken bones.

Bone pain is usually the initial symptoms, but sometimes the disease is diagnosed after the patient has:
– Anemia, due to plasma cell shifts the normal cells that produce red blood cells in bone marrow.
– Recurrent bacterial infections, because abnormal antibodies are not effective against infections.
– Kidney failure, due to an abnormal antibody fragments (Bence-Jones protein) damage the kidneys.

Sometimes multiple myeloma affects blood flow to the skin, fingers, toes and nose due to coagulation of blood (hyperviscosity syndrome). Decreased blood flow to the brain can cause neurological symptoms of confusion, impaired vision and headaches.

Diagnosis
Some blood tests may help in diagnosing this disease:

1. Complete blood counts, can be found anmeia and abnormal red blood cells
2. Erythrocyte sedimentation rate of red blood cells (erythrocytes) are usually high
3. High calcium levels, due to changes in bone causes calcium entry into the bloodstream.

But the key diagnostic tests for this disease is a serum protein electrophoresis and imunoelektroforesis, which is a blood test to find abnormal antibodies and to determine which is the typical sign of multiple myeloma. These antibodies are found in about 85% of patients. Elektroforesisi imunoelektroforesis urine and also can detect Bence-Jones proteins, at about 30-40% of patients.

X-rays often show bone loss (osteoporosis). Bone marrow biopsy showed large numbers of abnormal plasma cells that are arranged in rows and gangs; cells also looked abnormal.

TREATMENT
Treatment aims to:
- Prevent or reduce symptoms and complications
- Destroy the abnormal plasma cells
- Slow the progression of the disease.

Pain reliever (analgesic) is strong and radiation therapy on the bone is exposed, can reduce bone pain. Patients who had Bence-Jones protein in the urine should drink plenty of water to dilute the urine and helps prevent dehydration, which can cause kidney failure. Patients must remain active for a prolonged bed rest can accelerate the occurrence of osteoporosis and lead to easily broken bones. But it should not be running or lifting heavy loads for brittle bones.

In patients who have signs of infection (fever, chills, redness in the skin area) was given antibiotics. Patients with severe anemia may undergo blood transfusions or get erythropoietin (a drug to stimulate red blood cell formation). High blood calcium levels can be treated with prednisone and intravenous fluids, and sometimes with difosfonat (drugs to reduce levels of calcium). Allopurinol was given to patients who have high uric acid levels.

Chemotherapy to slow progression of the disease by killing the abnormal plasma cells. The most commonly used is melphalan and cyclophosphamide. Chemotherapy also kills normal cells, so blood cells were monitored and the dose adjusted if the number of white blood cells and platelets is reduced too much. Corticosteroids (eg prednisone or dexamethasone) are also provided as part of chemotherapy.

High-dose chemotherapy combined with radiation therapy is still in the research. This combination medication is very toxic, so that the stem cells before treatment should be removed from the blood or bone marrow patients and returned again after treatment is completed. This procedure is usually performed on patients under 50 years. In 60% of patients with treatment slows disease progression. Patients who respond to chemotherapy can last up to 2-3 years after the illness was diagnosed.

Sometimes patients who survived after treatment, could be suffering from leukemia or fibrous tissue (scar tissue) in the bone marrow. This further complication may be the result of chemotherapy and often causes severe anemia and increased sensitivity to infection sufferers.