Multiple myeloma describes a type of cancer which affects plasma cells, a type of white blood cell. Normally, plasma cells produce antibodies and, thus, play a role in the immune system, which functions to protect the body from infectious disease. However, in cancerous processes such as multiple myeloma, these cells become abnormal and are produced in large amounts. The unneeded cells produced are known as myeloma cells. These myeloma cells can collect in bone and bone marrow, usually simultaneously forming tumors in several bones, hence the name "multiple myeloma."

This disease can cause health problems in several ways. First, the myeloma lesions weaken bones, causing significant pain and increasing the risk for fractures. The damage to the bones also releases calcium into the blood. If blood calcium increases too greatly, it may cause symptoms such as decreased appetite, nausea, excessive thirst, fatigue, weakness, or confusion. Lesions in bone marrow prevent formation of normal blood cells. Having fewer white blood cells makes the body more susceptible to infection, while having fewer red blood cells (anemia) impairs the body's ability to deliver oxygen to its cells, causing fatigue and weakness. Finally, patients with mutliple myeloma are at risk for kidney disease, due to excess antibody from the myeloma cells and excess calcium from damaged bone, both of which impair the kidneys' ability to filter the blood.

UAMS is home to the Myeloma Institute for Research and Therapy. More information regarding multiple myeloma can be found at their website or at the multiple myeloma information page maintained by the National Cancer Institute.

Therapy
The UAMS Department of Radiology is actively involved in the care of patients with multiple myeloma. In addition to providing diagnostic support for the Myeloma Institute, UAMS Radiology is also involved in patient therapy. As mentioned previously, a common problem in multiple myeloma is the formation of lesions within the bone, which may lead to fractures. CT-guided biopsy of focal lesions can aid in diagnosis of multiple myeloma as well as provide prognostic information. As lesions and fractures associated with myeloma are commonly found in the vertebrae (the bones of the spine) and pelvis, patients with this condition may benefit from vertebroplasty, a therapy offered by interventional neuroradiology.

Research
Members of the department have also been involved in ongoing research on multiple myeloma. Radiology faculty have contributed to recent research projects, some of which are outlined in the following posters and abstracts:

• MRI-Defined Focal Lesions in Multiple Myeloma at Relapse are Often New Sites of Disease -- Presented by Dr. Walker at the 10th International Myeloma Workshop in Sydney, Australia, April 2005, this was the only poster on MRI at that meeting.
  
  
• Magnetic Resonance Imaging (MRI) as part of Staging Work-Up for Newly Diagnosed Multiple Myeloma (MM): Five (5) or More Focal Lesions and LDH Elevation Identify Inferior Survival in 402 Patients Receiving Total Therapy II (TT II)
  
  
• Prospective Evaluation of 460 Patients from Total Therapy II -- Identification of Characteristic on Baseline MRI Examinations of Prognostic Significance - Importance of Focal Lesions (FL) in Multiple Myeloma (MM)
  
  
• Analysis of Compression Fractures in Patients with Newly Diagnosed Multiple Myeloma on Comprehensive Therapy
  
  

Additional research articles on Multiple Myeloma from the UAMS Radiology Division of Nuclear Medicine:

• RHAMM expression and isoform balance predict aggressive disease and poor survival in multiple myeloma
  Blood 104:1151–1158, August 2004
  
  
• Multiple Myeloma: Clinical Review and Diagnostic Imaging
  Radiology 231:11–23, April 2004
  
  
• Treatment of Multiple Myeloma
  Blood 103:20–32, January 2004
  
  
• The Role of the Wnt-Signaling Antagonist DKK1 in the Development of Osteolytic Lesions in Multiple Myeloma
  The New England Journal of Medicine 349:2483-2494, December 2003
  
  

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