Müeloomi

Müeloomi, also known as myeloma, is a malignant neoplasm of plasma cells that primarily affects the bone marrow. The disease can be localized or involve multiple sites throughout the skeleton. The abnormal plasma cells proliferate and may produce a monoclonal protein. Müeloomi is the most common type of plasma cell cancer and is characterized by bone damage, anemia, kidney dysfunction, and immune suppression.

Pathophysiology: In müeloomi, clonal plasma cells accumulate in the bone marrow, disrupt normal hematopoiesis, and stimulate osteoclasts, leading to lytic lesions. These cells secrete monoclonal immunoglobulins (M-protein) detected in blood or urine; free light chains can also be abnormal. The disease can cause anemia, hypercalcemia, renal impairment, and infections.

Diagnosis and staging: Diagnosis relies on tests for monoclonal protein, bone marrow biopsy showing clonal plasma cells, and imaging to detect bone lesions. Assessments include kidney function, calcium, and blood counts. International Staging System (ISS) and cytogenetic risk groups help determine prognosis.

Treatment and management: Therapy aims to control disease, relieve symptoms, and extend survival. Induction therapy often includes a proteasome inhibitor, an immunomodulatory drug, and steroids, followed by autologous stem cell transplantation in eligible patients. Maintenance therapy and newer agents such as monoclonal antibodies are increasingly used. Supportive care includes bisphosphonates, infection prevention, and management of anemia and kidney problems.

Outlook: Survival has improved with modern therapies, though müeloomi remains incurable for most patients. Ongoing research explores targeted therapies, CAR-T cell therapy, and bispecific antibodies. Early diagnosis and tailored treatment plans are important for optimizing outcomes.