Multiple Myeloma Symptoms

By Dr Ananya Mandal, MD

The symptoms of multiple myeloma are not usually evident in the early stages of disease, which is often only detected or diagnosed as a result of routine blood and urine tests. As the condition progresses, however, various serious symptoms may manifest and affect multiple sites in the body which is why the condition is named multiple myeloma.

Examples of these symptoms include:

• Bone pain – In multiple myeloma, abnormal plasma cells (myeloma cells) are produced in high quantities which produce abnormal antibodies. The cells proliferate and expand throughout the bone marrow eventually damaging the bone, which can become sore and painful. The most frequent sites of bone pain include the spine, the lower back, the rib cage and the hips. The pain is dull, aching and persistent and may be aggravated on impact or movement.
• Susceptibility to bone fracture – As the cancer progresses, the bones become increasingly thin, fragile and prone to fracture. The majority of fractures involve the spine. Fracture to the vertebrae can cause segments of the spine to collapse and crush together. This can cause compression of the spinal cord nerves which leads to pain, numbness and weakness in the lower limbs. Compression of the spinal nerves can also cause incontinence issues.
• Generalized symptoms of multiple myeloma include unexplained fatigue, bone pain and weight loss.
• Anemia – Either multiple myeloma itself or treatment for the condition may lower the red blood cell count and cause anemia which may lead to weakness, fatigue and shortness of breath.
• Low immunity or recurrent infections – The spread of myeloma cells throughout the bone marrow may also cause depletion of the white blood cells, lowering immunity and leaving a patient vulnerable to infections.
• Bleeding and bruising tendencies – Blood platelets, which are involved in the blood clotting process are also made in the bone marrow and multiple myeloma can lead to a depleted platelet count and an increased tendency to bruise and bleed. An individual may bleed easily after just a small scratch or start to experience nose bleeds, for example.
• Kidney damage – Myeloma cells produce an abnormal protein that can damage the kidneys as they pass from the blood and into the urine. In addition, some of the treatments used to treat myeloma can damage the kidneys.

Reviewed by Sally Robertson, BSc

Further Reading

• What is Multiple Myeloma?
• Multiple Myeloma Diagnosis
• Multiple Myeloma Pathophysiology
• Multiple Myeloma Treatment
• Multiple Myeloma Epidemiology
• Management of Myeloma