How is it determined whether end-organ damage is attributable to myeloma?
Plasma cells are the cell lines that recognize antigen and produce antibiotics to fight against infections. Multiple myeloma is the cancer of plasma cells. Abnormal/cancerous plasma cells gather in bone marrow and finish normal healthy cells. These cancerous cells produce abnormal proteins. There may not be any symptoms in the beginning of the disease but in later stages: bone pains, nausea, constipation, loss of appetite, confusion, fatigue, recurrent infections, weight loss, peripheral numbness or excessive thirst may develop. The cause of the disease is unknown. It starts with production of one cancerous cell in the bone marrow, this cell has an abnormal life span. The number of divisions is also not normal hence producing more cancerous cells than normal. These cancerous cells also try to produce antibodies, instead produce abnormal proteins called M-protein or monoclonal proteins. These proteins deposit in different organs and effect their function such as renal tissue. The condition is thought to be preceded by production of 2 antibodies call MGUS (monoclonal gammopathy of undetermined significance) or SMM (smoldering multiple myeloma). Patients with these two can progress to multiple myeloma. Myeloma kidney disease is seen on renal biopsy when free light chains of more than 1000mg/l present.