26/03/2025

Multiple myeloma is a complex disease that is sometimes difficult to diagnose, however science is advancing, enabling us to learn more and better help people manage the condition.

Myeloma is a blood cancer that develops in plasma cells, which are a type of white blood cell found in the bone marrow.¹ These cells play a crucial role in the immune system by producing antibodies that help fight infections.¹ In myeloma, abnormal plasma cells multiply uncontrollably and crowd out normal cells in the bone marrow.² Additionally, the abnormal plasma cells produce abnormal antibodies referred to as M-protein or paraproteins, which build up and can cause damage to the kidneys and other organs.² As myeloma affects several areas of the body, it is sometimes referred to as multiple myeloma.³

Myeloma is a relapsing-remitting cancer, which means that there are periods where symptoms get worse (a relapse, whilst the cancer is active), followed by recovery (remitting, where the cancer is not active).¹

Around 6,000 people are diagnosed with myeloma each year in the UK.⁴ Although it is more common in people over 65 years of age, it can also impact people much younger.¹

Diagnosing myeloma can be challenging. Symptoms often develop slowly over time and can be attributed to many other conditions making it difficult to identify.⁵ This may lead to delayed medical attention and often involves several visits to a GP before seeing a specialist.⁶ Diagnosis requires a combination of blood and urine tests (to check for antibodies and proteins), imaging technology such as CT and MRI scans (used to check bone damage) and bone marrow biopsies (to help identify cancerous plasma cells).⁵

Typical symptoms can include:⁷

• Bone pain: Often felt in the back, hips, or ribs.
• Bone fractures and spinal cord compression: Myeloma can weaken the bones and make them more likely to break (fracture).
• Anaemia: Low levels of red blood cells may lead to people feeling tired, weak, and breathless.
• Frequent infections: Weakened immune system makes it harder to fight infections.
• Raised calcium levels: Symptoms can include extreme thirst, feeling sick, stomach pain, frequent urination, constipation and confusion.
• Bruising and unusual bleeding: Cancer cells in the bone marrow can stop blood-clotting cells called platelets from being made.
• Thickened blood: Excess proteins in myeloma cells can thicken blood leading to problems such as blurred vision, headaches, dizziness, bleeding from gums or nose, shortness of breath.
• Kidney problems: Signs of kidney failure can include weight loss and poor appetite, swollen ankles, feet or hands, tiredness, shortness of breath, itchy skin, feeling sick, hiccups that won't go away.

As a result of better diagnosis, an improved understanding of the disease, and advancement in therapies, there has been significant progress in survival rates. Ten-year survival has improved from 6.4% in the 1970s to 32.5% by the 2010s.⁴ This means more people are living longer after their diagnosis.

However, myeloma poses a scientific challenge, as myeloma cells can develop genetic changes as they grow and multiply. This means myeloma cells are not all the same and are made up of different groups of cells called ‘clones’.⁸ Some treatments may therefore only be effective against a specific ‘clone’ leaving others unaffected.⁸

While myeloma is currently incurable, the aim of treatment is to reduce symptoms, control disease progression and improve quality of life.¹ There are many treatment options, including chemotherapy, steroids, stem cell transplants, immunotherapy and targeted therapy.⁹ Recent advancements in medicines have also introduced the following:

• Bispecific antibodies: medicines that target two different antigens/proteins, and use your immune defence, to provide a ‘two-pronged attack’ against the cancer.¹⁰

• CAR T-Cell therapy: Modifying a patient’s T-cells (part of your immune defence) to better recognise and attack myeloma cells.¹¹

• Combination therapies: Where multiple medicines are used together to fight the disease.¹²

A diagnosis can be overwhelming, so support and resources are crucial for patients and their families. There are several myeloma patient charities in the UK, as well as wider support groups, that provide a range of services, including emotional and practical support, counselling, financial advice, and tips on how to make the right treatment decisions with your care team.

To help people living with myeloma and their care partners, Pfizer has launched Myeloma and Me. This website aims to help people stay positive and take control of their future, by identifying what is most important to them and how to communicate these priorities to a healthcare team. In partnership with Blood Cancer UK, Pfizer has also launched a blood cancer patient charter, designed to give patients information about their care journey.

As scientific understanding of myeloma improves and advances in treatment, diagnosis and support systems continues, there is hope for patients.

While there is still much to learn, Pfizer is committed to investing in research to better understand the disease and discover novel therapies to help improve the lives of people with myeloma and their families.