Multiple Myeloma (MM)

Multiple myeloma (MM) is a blood cancer of plasma cells in the bone marrow, causing abnormal cells to multiply, crowd out healthy blood cells, and form tumors, leading to symptoms like bone pain, fatigue, anemia, kidney problems, and infections. 

MM and calcium:

In myeloma patients, the primary cause of the hypercalcemia is widespread tumor-induced bone destruction.  

Because myeloma patients often have irreversible impairment in renal function and increased renal tubular calcium reabsorption, the capacity of the kidneys to clear excess calcium load from the circulation effectively is overwhelmed, resulting in elevated serum calcium levels.

M Protein 

An antibody found in unusually large amounts in the blood or urine of people with multiple myeloma and other types of plasma cell tumors. Also called monoclonal protein.

Monoclonal antibodies are used therapeutically in the treatment of cancer. They bind only to cancer cells and induce an immune response against the target cancer cell.

Daratumumab (Darzalex) is an anti-cancer M protein (monoclonal antibody) medication delivered by  IV infusion. It seems to work both by killing the cancer cells directly and by helping the immune system attack them. Treatment with daratumumab potentially increases the patient's susceptibility to bacterial and viral infections.

At one time, "Traditional" Chemotherapy  was often part of the main treatment for multiple myeloma. As newer types of drugs have become available in recent years, chemo has become less important in treating myeloma. 

Examples of chemo drugs administered by IV or pill 

Cyclophosphamide (Cytoxan)

melphalan (Alkeran) 

Bendamustine (Treanda)

Doxorubicin (Adriamycin)

Etoposide (Etopophos, Toposar, VP-16)

Liposomal doxorubicin (Doxil)

Velcade “chemo”

Velcade (bortezomib) is an anti-cancer drug, a proteasome inhibitor, used primarily for treating multiple myeloma and mantle cell lymphoma by blocking enzymes (proteasomes) that cancer cells rely on to break down proteins, ultimately causing cell death. Administered by injection, it's used at various stages of multiple myeloma, including newly diagnosed and relapsed cases, often with other therapies, and can cause side effects like neuropathy (numbness/weakness) and fatigue, requiring careful management.