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High calcium, anaemic, spinal compression fracture, bone pain. Diagnosed multiple myeloma. Taking thalidomide, prednisone. What is the cancer stage?

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My sister-in-law in 31 years old and diagnosed with Multiple Myeloma. We have been told that she has high calcium in her blood, she is severely anaemic (already has a blood transfusion) , she has suffered a spinal compression fracture and cannot walk because of bone pain , apparently becos of lesions in her pelvis , spine , rib cage . She has 86g/L of some protein which should be at 0g/L .90% of her bone marrow is myeloma cells, BUT her kidneys are fine. Her doctor has started her on thalomide and pednisone and suggested that she needs to have a stem cell tranplant.
What stage of cancer is she and what is her prognosis, life expectancy. Can we positively expect that she will achieve remission ?
Posted Thu, 31 May 2012 in Cancer
Answered by Dr. Indranil Ghosh 6 hours later

Thanks for writing in.

Overall, all the details fit into the diagnosis of Multiple Myeloma. Myeloma is a cancer of the plasma cells in the bone marrow, the spongy tissue inside of bones. Myeloma begins when normal plasma cells change and grow uncontrollably. Plasma cells are a part of the body's immune system and produce antibodies that help the body fight infection. Abnormal plasma cells can suppress the growth of other cells in the bone marrow that produce red blood cells, white blood cells, and platelets. This suppression may result in anemia (from a shortage of red blood cells), and a decreased ability to fight infection.

However, as the myeloma cells grow uncontrollably, there is overproduction of antibodies, leading to an accumulation in the blood and urine that may cause damage to the kidneys and other organs. This is the protein you are referring to.

Myeloma often causes structural bone damage resulting in painful fractures. Calcium is high because of bone destruction. However, it is good that the kidneys are fine.

As of now, myeloma is controllable but not curable. Thalidomide-dexamethasone is fine as treatment but I would prefer bortezomib as it produces higher responses. Stem cell transplant after this improves survival.

Life expectancy is around 4-5 yrs on an average. I am sure she will do well, at least in short term. But, unfortunately, all patients will eventually die of this.

Hope I have answered your query. I will be happy to answer any follow-up queries.
Take care.
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