Multiple Myeloma
Multiple myeloma is a cancer of plasma cells, the antibody-producing cells normally found in bone marrow. Abnormal plasma cells multiply and crowd the marrow, produce an abnormal protein, and can weaken bones, impair kidney function, and lower normal blood cell counts. It typically affects older adults and is diagnosed through blood, urine, and bone marrow testing.
Understanding Multiple Myeloma
Plasma cells are white blood cells that normally produce antibodies to help fight infection. In multiple myeloma, a single abnormal plasma cell multiplies uncontrollably within the bone marrow, and these cells produce large amounts of a single, non-functional antibody protein known as monoclonal protein, or M-protein. As abnormal plasma cells accumulate, they crowd out normal marrow function, weaken bone, and can affect kidney function through the abnormal protein circulating in the blood.
Diagnosis and disease activity are often described using the CRAB criteria, an acronym for the key effects of myeloma: elevated Calcium, Renal (kidney) impairment, Anemia, and Bone lesions. Multiple myeloma often develops from earlier, symptom-free states called MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma, which are monitored over time because only some cases progress to active disease requiring treatment.
Multiple myeloma typically follows a relapsing-remitting course, meaning that periods of disease control after treatment can be followed by relapse requiring further therapy. Because of this pattern, care usually includes maintenance therapy after initial treatment and long-term monitoring, with treatment choices adjusted based on how the disease responds and its underlying genetic risk features.
Signs of Multiple Myeloma to watch for
When to see a haematologist
Persistent, unexplained bone pain in an older adult, particularly back pain that does not improve with rest, should be investigated rather than attributed to age alone.
Fatigue combined with abnormal kidney function or elevated calcium on blood tests warrants haematology referral for further evaluation.
A fracture occurring after minor trauma should prompt evaluation for an underlying bone-weakening condition.
Tests offered at the centre
Serum Protein Electrophoresis and Immunofixation
Blood tests that detect and characterise the abnormal monoclonal protein produced by myeloma cells, a key step in diagnosis and disease monitoring.
Serum Free Light Chain Assay
Measures light chain proteins in the blood, useful for diagnosis, risk assessment, and tracking response in patients whose myeloma does not produce a typical monoclonal protein.
Bone Marrow Aspiration and Biopsy
Confirms the proportion of abnormal plasma cells in the marrow and provides tissue for cytogenetic testing used in risk stratification.
Whole-Body Imaging
Skeletal survey, MRI, or PET-CT is used to detect bone lesions caused by myeloma, guiding both diagnosis and bone-protective treatment decisions.
Cytogenetic and FISH Testing
Identifies specific chromosomal changes within myeloma cells that help classify disease risk and inform treatment intensity.
Treatment options
Your treatment plan is personalized to your diagnosis, subtype and overall health.
Induction Therapy
Combination regimens using proteasome inhibitors, immunomodulatory drugs, and steroids aim to reduce the burden of abnormal plasma cells before further treatment, following current protocols.
Autologous Stem Cell Transplant
For eligible patients, high-dose therapy followed by reinfusion of the patient's own previously collected stem cells is used to deepen and extend disease control.
Maintenance Therapy
Lower-intensity treatment continued after induction or transplant aims to prolong disease control and delay relapse.
Bone-Protective Treatment
Bisphosphonates or related agents help reduce the risk of fractures and manage bone involvement associated with myeloma.
Supportive Care
Management of anemia, infection risk, and kidney protection is integrated throughout treatment to support overall health during therapy.
Why choose AP Blood & Blood Cancer Centre
Multiple myeloma requires coordinated interpretation of blood protein studies, bone marrow findings, imaging, and cytogenetics before a treatment plan can be finalized. As a single-specialty haematology centre, this diagnostic pathway is managed in one focused setting rather than across multiple unconnected departments.
Dr. Amarnadh Polisetty, MBBS, MD (General Medicine), DNB (Clinical Haematology), has over 7 years of experience in clinical haematology and has been part of specialist transplant teams that have managed more than 500 bone marrow transplant patients, including autologous transplants relevant to myeloma care, along with an ASH Abstract Award. Treatment planning is personalized to disease risk category and follows internationally aligned protocols.
Common questions about Multiple Myeloma
Medically reviewed by Dr. Amarnadh Polisetty, MD, DNB (Clinical Haematology)
Last reviewed on 1 July 2026
Experiencing unexplained bone pain or fatigue?
Persistent bone pain, fatigue, or abnormal blood and kidney test results deserve evaluation by a clinical haematologist.