Multiple myeloma is a bone marrow cancer affecting plasma cells, a type of white blood cell and part of the immune (disease-fighting) system. Plasma cells produce antibodies, proteins that attack bacteria and viruses. When the body makes too many plasma cells (called myeloma cells) it develops into a plasma cell neoplasm like multiple myeloma.
Multiple myeloma often starts with a condition called monoclonal gammopathy of undetermined significance (MGUS), which is noncancerous precursor state. In infrequent cases, however, it develops into multiple myeloma.
If your primary care doctor suspects you have multiple myeloma, they may order tests and procedures to confirm a diagnosis. Blood and urine tests are often the first step to making a diagnosis of multiple myeloma. A bone marrow biopsy, in which a tissue sample is taken and analyzed for myeloma cells, confirms the diagnosis. These tests are then complemented by imaging tests (e.g., X-rays, magnetic resonance imaging [MRI], computed tomography [CT] scans, PET scans).
At Mass General Brigham, we bring extensive experience in diagnosing and treating multiple myeloma, MGUS and related plasma cell disorders.
If you are diagnosed with multiple myeloma, your care team at Mass General Brigham will work with you and family members to develop a personalized treatment plan. Multiple myeloma is a complex disease, so we assemble experts from an assortment of disciplines to give you the best chance at a successful outcome. Your care team may include medical oncologists, bone marrow transplant specialists, orthopedic oncologists and members of many other specialties. Part of what makes Mass General Brigham skilled in myeloma care is that from the very beginning of your care, your cancer team includes specialists in every possible myeloma treatment option – and together, all these doctors are working together, constantly evaluating, shifting and preparing new approaches in response to how your body and care are responding – in some patients, multiple treatment modalities are used.
Multiple myeloma therapies have evolved dramatically in the last 15-20 years. At Mass General Brigham, you will find all the latest treatments for multiple myeloma, including:
Observation, also called "watchful waiting," may be suitable for patients with smoldering myeloma (which has no symptoms). In these cases, the disease is carefully monitored until it progresses or symptoms emerge. Innovative approaches such as vaccinations, diet and exercise interventions are currently under investigation
Chemotherapy uses drugs (given intravenously or orally) to destroy myeloma cells including immunomodulatory drugs, proteasome inhibitors and monoclonal antibodies.
Radiation therapy uses high-energy beams, such as X-rays, to shrink or kill myeloma cells without damaging healthy normal cells around the tumor. It may be used in addition to chemotherapy if multiple myeloma has weakened your bones.
Targeted therapy is a form of personalized medicine in which a drug is chosen based on the specific genetic mutation or alteration found in your own cells.
Chimeric antigen receptor (CAR) T-cell therapy is a form of immunotherapy that involves engineering T-cells (a type of white blood cells) to find and attack myeloma cells. It is one of the newest, most promising treatments for multiple myeloma in adults. Learn more about CAR T-cell therapy.
Bone marrow transplant may involve using stem cells from your own body (autologous transplant) or from a donor (allogenic transplant). With autologous transplant, stem cells from your bone marrow are collected and stored, administered high-dose chemotherapy and then returned to your body through an infusion. Our bone marrow transplant program brings high-volume expertise in both procedures and is advancing the field through clinical trials and other research studies.
Surgery is not a standard therapy for multiple myeloma. However, your care team may include orthopedic surgeons who specialize in caring for patients whose bones have become weakened or fractured by multiple myeloma.
Meet Mass General Brigham's multidisciplinary team of multiple myeloma specialists.
Each year, thousands of patients from more than 140 countries travel to Mass General Brigham for medical care, second opinions and treatments unavailable anywhere else in the world.
Mass General Brigham cancer teams are experienced in caring for multiple myeloma patients who are traveling great distances to our hospitals in Boston. Your cancer team here and our international patient services team will help you prepare for and plan the appropriate amount of time to stay in Boston for your appointments, treatments and any recovery time. During this recovery time in Boston or back home in your country, our clinical team will monitor your well-being and progressions to continuously optimize your treatment plan and symptoms.
Many of our international patients have questions about everything from travel and lodging to scheduling appointments. Our international patient services team is here to help. We look forward to making your Mass General Brigham experience as healing and stress-free as possible.