Myeloma (also known as multiple myeloma) and amyloidosis are serious conditions that share a common marker: they’re caused by abnormal plasma cells found in bone marrow. While myeloma (a blood cancer) and amyloidosis (a blood disease) can develop independently of one another, they’re frequently diagnosed together.
Understanding myeloma vs. amyloidosis
While myeloma and amyloidosis both start in plasma cells found in bone marrow, the key difference between them is how the plasma cells are affected.
Imagine white blood cells as security guards in your bloodstream that are constantly on patrol for disease and infection. When they’re alerted to potential harm, they spring into action by changing into plasma cells that ultimately produce proteins known as antibodies (also called immunoglobulins). These antibodies bind to the harmful substances, remove them from your body and leave your bloodstream once their job is done.
Myeloma occurs when plasma cells multiply and produce atypical antibodies. The malignant plasma cells grow out of control to the point that there’s not enough space in the bone marrow for healthy cells to fight infection or disease. Meanwhile, in amyloidosis, abnormal proteins called amyloids mutate into twisted clumps that build up on your organs and tissues.
Plasma cell diseases change your body’s healthy rhythm. When you feel or suspect that something is off, know that our team of experts is well-versed in treating the following plasma cell conditions:
Myeloma with AL amyloidosis
Myeloma is often diagnosed with the most common type of amyloidosis, known as amyloid light-chain (AL) amyloidosis. Each antibody your plasma cells produce includes pieces called light chains.
AL amyloidosis happens when, specifically, the light chain proteins misfold, multiply and clump together on the:
- Kidneys (in 50% of people)
- Heart (in 50% of people)
- Liver (in 25% of people)
- Gastrointestinal tract (in 25% of people)
The National Institutes of Health published a 2021 study revealing an estimated 10–15% of people with myeloma develop AL amyloidosis, and about 10% of people with AL amyloidosis have symptomatic myeloma at the time of diagnosis.
We turn to the following 3 tests to diagnose myeloma and amyloidosis:
- Protein immunofixation electrophoresis: This test measures certain proteins in your blood.
- Bone marrow biopsy and aspiration: This is a standard test we perform during your initial consultation. In bone marrow aspiration, your doctor will take a sample of the liquid part of your bone marrow called stem cells. For a biopsy, your doctor will take a solid sample to examine. We can also perform this test if you’re not responding to treatment or when you’re pre- or post-transplant.
- Cytogenetic evaluation: Part of your bone marrow aspiration sample may be examined for chromosomal abnormalities (cytogenetic evaluation). The lab may examine dividing cells or may perform a fluorescence in situ hybridization (FISH) analysis to look for chromosomal changes.
Tracking your body’s response to treatment
The hallmark of plasma cell diseases is antibody proteins called immunoglobulins. Plasma cells produce an identifiable immunoglobulin signature with a heavy chain and a light chain.
We follow these signatures during therapy because as the number of malignant cells decreases, these proteins decrease as well. This is a clear sign that the person is responding to treatment.
One of the most rewarding moments in a person’s health journey is learning that they’re disease-free. We’re able to share that momentous news when we can no longer identify signature proteins.
It’s important to know that myeloma and amyloidosis will require lifelong care because relapsing is common. Relapse occurs because a very small amount of the disease remains in the body even after we cannot find signature proteins in the blood or urine. This is called minimal residual disease.
We can better understand your risk of relapse by testing your minimal residual disease.
A principle that applies to all plasma cell diseases is that early diagnosis and treatment offer the best outlook for your overall wellness. The sooner we can control the plasma cell disease and reverse potential organ damage, the sooner we can offer you the comfort and quality you look forward to in life.
Our top goal for treating plasma cell diseases like myeloma and amyloidosis is to target the cancerous plasma cells with approaches like:
- Stem cell transplantation
- Bone marrow transplantation
- Affected organ or tissue transplantation (like the heart)
- Radiation therapy
We’re always pursuing what’s next in healthcare and what’s next for your health. We welcome people living with plasma cell diseases to ask us about our latest research and how to participate in available clinical trials.
Treating myeloma with AL amyloidosis
Treating multiple myeloma with AL amyloidosis involves targeting the cancerous plasma cells. We can approach this with an autologous stem cell transplant, where stem cells are collected from your blood and transplanted back into your body following chemotherapy.