Myeloma is not a one-treatment-fits-all cancer. Although it starts in the bone marrow, affecting plasma cells and causing a mass or tumor, the disease takes different forms from there.
The most common form is multiple myeloma, in which the cancer affects several areas of the body. Other forms are plasmacytoma, in which only one site is affected, such as the bone, skin, muscle or lung; localized myeloma, in which neighboring sites are affected; and extramedullary myeloma, in which tissue other than bone marrow is affected, such as skin tissue, muscle tissue or lung tissue.
The complexity doesn't stop there, and March – which happens to be Myeloma Awareness Month – is a fine time to take note of just how complicated myeloma can be. The disease is also categorized based on how rapidly or slowly it's progressing, according to the Leukemia & Lymphoma Society. Asymptomatic, or smoldering, myeloma moves slowly and causes no symptoms; symptomatic myeloma produces anemia, kidney damage and bone disease.
The most significant risk factor is age. As the Centers for Disease Control and Prevention notes, people under 45 are unlikely to develop myeloma, which occurs most often in people 67 and older. Further, men are more likely to develop myeloma than women, and African-Americans are more likely to develop it than whites.
"Myeloma has become a disease with very individualized treatment," she says, "and therefore we encourage patients to seek consultation at centers with specialization in the disease to best tailor therapy for them.
"High-dose chemotherapy with stem cell rescue, also known as stem cell transplantation, may be part of the treatment for myeloma," she adds. Further, City of Hope is one of the leading transplant centers, recognized internationally for its treatment of myeloma and other blood disorders.
Here, specialized experts stay abreast of treatment developments – one of which occurred in February with the approval of the drug pomalidomide for the treatment of multiple myeloma in patients who have received at least two prior therapies.
"We are very excited that pomalidomide was approved for relapsed myeloma," Krishnan says.
But City of Hope experts are always pushing further, looking for the next breakthrough in treatment and, maybe, cure. "We are committed to treating patients at any stage of their disease with trials – from newly diagnosed patients to relapsed patients," Krishnan says.
That's how discoveries happen.
And with myeloma, the second most-common blood cancer behind leukemia (which affects bone marrow and blood), the discoveries are about the individual.