Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
Send us all your questions or requests, and our expert team will assist you.
Multiple Myeloma is notoriously difficult to detect in its early stages because symptoms can be vague, nonspecific, or entirely absent. Many patients are diagnosed incidentally during routine blood tests for other conditions. However, as the burden of myeloma cells increases, specific symptoms related to organ damage begin to emerge. Clinicians use the acronym “CRAB” to describe the four classic symptoms of active myeloma: Calcium elevation, Renal insufficiency, Anemia, and Bone abnormalities. Recognizing these signs and understanding the underlying risk factors is crucial for timely diagnosis and intervention. At Liv Hospital, we emphasize that persistent bone pain or unexplained fatigue should never be ignored.
Calcium Elevation (Hypercalcemia)
When myeloma cells destroy bone, calcium is released from the bone into the bloodstream.
Systemic Effects
High levels of calcium (hypercalcemia) can cause a constellation of symptoms. Patients may experience extreme thirst, frequent urination, dehydration, severe constipation, and loss of appetite.
Neurological Impact
Severe hypercalcemia can affect the brain, leading to confusion, lethargy, “brain fog,” and in extreme cases, coma. This is considered a medical emergency.
The kidneys are frequently a target of damage in myeloma.
Cast Nephropathy
The excess antibody proteins (light chains) produced by the cancer cells can accumulate in the kidney tubules. They form solid casts that block the flow of urine, effectively clogging the kidney’s filtration system.
Toxic Effects
High calcium levels also damage kidney tissue directly. Symptoms of kidney failure include swelling in the legs (edema), weakness, and shortness of breath due to fluid retention. Unlike other kidney diseases, myeloma related kidney failure often happens rapidly.
Anemia
Anemia is one of the most common symptoms, present in nearly two thirds of patients at diagnosis.
Marrow Crowding
As the myeloma cells multiply, they physically crowd out the healthy hematopoietic stem cells that produce red blood cells.
Reduced Erythropoietin
Kidney damage reduces the production of erythropoietin, a hormone needed to signal the bone marrow to make red blood cells. The result is fatigue, pale skin, dizziness, and shortness of breath during daily activities.
Bone disease is the hallmark of myeloma, affecting up to 85 percent of patients.
Lytic Lesions
The imbalance between bone destruction and bone formation leads to “punched out” holes in the bones called lytic lesions. These are weak spots that are prone to breaking.
Pathologic Fractures
Bones can break with very little force, such as a rib fracture from coughing or a vertebral compression fracture from bending over.
Pain Patterns
Bone pain is often described as a deep, gnawing ache. It is most common in the back, ribs, and hips. The pain is typically worse with movement and does not improve with standard rest, distinguishing it from simple muscle strain.
Spinal Cord Compression
If a myeloma tumor grows on the vertebrae of the spine, it can press outward onto the spinal cord.
Emergency Signs
This causes severe back pain, numbness or tingling in the legs, and muscle weakness. If left untreated, it can lead to permanent paralysis and loss of bladder or bowel control.
Peripheral Neuropathy
The M protein itself can sometimes damage nerves, or neuropathy may be a side effect of treatments. This manifests as a “pins and needles” sensation or burning in the hands and feet.
Thickened Blood
In some patients, the level of M protein in the blood is so high that it increases the viscosity (thickness) of the plasma.
Circulation Impairment
Thick blood flows slowly, impairing the delivery of oxygen to tissues.
Symptoms
This can cause headaches, dizziness, blurred vision, nosebleeds, and shortness of breath. It puts extra strain on the heart and can lead to stroke like symptoms.
Immune Paresis
Although myeloma cells produce antibodies, they are useless. Meanwhile, the production of normal, protective antibodies is suppressed.
Recurrent Illness
Patients are highly susceptible to bacterial infections, particularly pneumonia, urinary tract infections, and sinus infections. An infection that a healthy person would fight off easily can become life threatening for a myeloma patient.
Non Modifiable Factors
Certain biological traits increase susceptibility.
Age
The risk increases significantly with age. It is most frequently diagnosed in people aged 65 to 74.
Race
African Americans have more than double the incidence rate of myeloma compared to white Americans. The reason for this is thought to be genetic, as the prevalence of the precursor condition MGUS is also higher in this population.
Family History
While most cases are sporadic, having a first degree relative (parent or sibling) with myeloma or MGUS slightly increases risk.
Environmental and Lifestyle Factors
External exposures may trigger the genetic mutations.
Chemical Exposure
Studies have shown associations between myeloma and exposure to certain agricultural chemicals, pesticides, benzene, and Agent Orange.
Obesity
Being overweight or obese is associated with a higher risk of developing myeloma. Adipose tissue creates a pro inflammatory environment that may support the growth of myeloma cells.
Radiation
Exposure to high levels of radiation is a known risk factor for many blood cancers, including myeloma.
Send us all your questions or requests, and our expert team will assist you.
It is usually a persistent, deep ache in the back or ribs that gets worse with movement and doesn’t go away with rest or standard painkillers.
The cancer cells crowd out healthy white blood cells and stop the body from making normal antibodies, leaving the immune system weak.
There is no specific food that causes it, but obesity is a risk factor, so maintaining a healthy weight is important for prevention.
It is a broken bone that happens because the bone has been weakened by disease (like a lytic lesion), often occurring with only minor force.
Yes, high calcium levels can cause kidney failure, confusion, and even coma, so it requires immediate medical treatment.
Your Comparison List (you must select at least 2 packages)
