[Focus! Health] Blood Cancer 'Dabalgolsujong'... How Can It Be Treated?

[Image source=Pixabay]

Last month on the 30th was designated as ‘International Myeloma Day’ to raise global awareness of multiple myeloma and to wish for its cure.

Multiple myeloma is a type of blood cancer in which plasma cells, a kind of white blood cell, become malignant and proliferate excessively. This overgrowth mainly occurs in the bone marrow. The cancer cells in multiple myeloma secrete abnormal proteins called M proteins, which cause various symptoms.

According to the National Cancer Information Center, the prevalence of multiple myeloma is 10.7 per 100,000 people, accounting for 0.6% of all cancers. It rarely occurs at a young age but the incidence increases from the 40s and is known to be most frequent in the 70s.

The exact cause of multiple myeloma has not yet been clearly identified. Exposure to radiation, pesticides, insecticides, benzene, and other chemicals, as well as genetic factors, are suspected risk factors, but no definitive causal relationship has been established.

The representative symptoms of multiple myeloma include bone weakening and resulting fractures, bone pain, anemia, kidney dysfunction, hypercalcemia, and infections. When these symptoms appear, the disease is often quite advanced. If a compression fracture occurs in the spine, it is more likely to be a pathological fracture caused by an underlying disease such as multiple myeloma rather than trauma. However, in such cases, non-hematology departments may overlook this, and only conduct tests and treatments for common spinal compression fractures, which can delay proper treatment, so caution is necessary.

If multiple myeloma is left untreated, various symptoms can worsen. Fractures can occur throughout the body including the arms and legs, and spinal compression fractures can cause the spine to collapse, resulting in pain. In severe cases, nerve compression can lead to paralysis symptoms. Additionally, kidney dysfunction can progress to chronic renal failure requiring dialysis. Multiple myeloma affects various organs and significantly impairs quality of life.

Professor Kim Dae-sik of the Department of Hematology and Oncology at Korea University Guro Hospital said, “Multiple myeloma does not show typical symptoms in the early stages, so early detection through regular check-ups is important. Especially if abnormal fractures occur or bone pain persists, it is advisable to visit a hematology department for accurate testing.”

Professor Dae-Sik Kim, Department of Hematology and Oncology, Korea University Guro Hospital
[Photo by Korea University Guro Hospital]

The basic treatment for multiple myeloma is immuno-oncology therapy. Previously, cytotoxic chemotherapy was the main treatment, but recently various targeted therapies and immuno-oncology drugs have been developed and are being used. Representative treatments include immunomodulatory drugs, proteasome inhibitors, antibody therapies, cytotoxic chemotherapy, and steroids, which are combined in various regimens for comprehensive treatment.

Treatment through autologous hematopoietic stem cell transplantation is also performed. Hematopoietic stem cells are cells produced in the bone marrow that generate various blood cells such as white blood cells, red blood cells, and platelets. Autologous hematopoietic stem cell transplantation is a treatment method in which the patient’s own stem cells are collected in advance and transplanted to help rebuild the damaged bone marrow after high-dose chemotherapy. This procedure is applied only to patients who are eligible based on their age and condition.

Patients with multiple myeloma often suffer from complications caused by the disease itself or the treatment process. Medications to prevent fractures and bone pain are used, and active pain management with analgesics is necessary when pain is severe. Preventive antibiotics are also used because infections such as pneumonia can lead to dangerous situations, and caution is required when using drugs due to frequent kidney dysfunction. Additionally, allergic reactions such as skin rashes, thrombosis, peripheral neuropathy, and heart failure are common side effects, so careful treatment is essential.

Professor Kim said, “Multiple myeloma is known to be a difficult disease to treat, but new treatments are being developed rapidly and are being used in clinical practice, leading to remarkable improvements in treatment outcomes. In particular, the recent domestic approval of the chimeric antigen receptor (CAR)-T cell therapy ‘Karbity’ is expected to be a great help in treating relapsed and refractory multiple myeloma patients.”