HAEMATOLOGY
Overcoming the barriers preventing early diagnosis of multiple myeloma
For a common condition, multiple myeloma is challenging to diagnose, meaning it is often missed in the early stages. Dale Powner examines how it is discovered, recent advances in diagnostic technologies, and what is required to improve clinical practice.
Multiple myeloma (MM) is the second most common haematological malignancy in the UK, accounting for at least 2% of all cancer-related deaths and claiming approximately 3,000 lives each year.1
This sobering
statistic highlights the pressing need for better awareness, timely diagnosis and effective management of this challenging condition. Unfortunately, MM often goes undetected until its later stages due to non-specific symptoms2
– including
fatigue, weight loss, bone pain and recurrent infections3
– but, as with many
cancers, early detection is a critical factor in improving outcomes. In fact, early diagnosis has the potential to be the most effective ‘treatment’ available for MM patients, offering them the best chances of a better quality of life and long-term survival. This article examines the current challenges in diagnosing MM, advances in diagnostic technologies, and the systemic changes needed to close the gap between research and clinical practice.
Understanding multiple myeloma
MM is a type of blood cancer that develops when plasma cells in the bone marrow become cancerous. Plasma cells are a subset of white blood cells responsible for producing antibodies
to combat infections. When these cells become cancerous, they produce large amounts of monoclonal proteins (M proteins), commonly known as paraproteins, which lack the ability to defend against infections.3
the proliferation of cancerous plasma cells in the bone marrow suppresses the production of healthy blood cells,
leading to low counts of red blood cells, other white blood cells and platelets.3,4 This disruption can lead to complications such as anaemia, immunosuppression, increased susceptibility to infections, and various types of organ damage.
n Disease subtypes While an overproduction of paraproteins is a defining feature of MM, there are various disease subtypes that deviate significantly in their clinical presentation and underlying pathology.5
The most Furthermore,
common type of myeloma – accounting for over 80% of cases – is characterised by the over-production of a monoclonal intact immunoglobulin. The IgG subtype is the most common form, followed by IgA and then IgM. In addition to these better-known subtypes, other rare forms of MM exist, including IgD
Multiple myeloma in a smear preparation from a bone marrow aspirate (May-Grünwald-Giemsa staining).
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