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Multiple myeloma

Multiple myeloma is a type of cancer of the lymphatic system that consists of a proliferation of plasma cells. These cells produce the antibodies that protect us from infections and other foreign substances that might enter our organism (antigens).

Plasma cells are normally found in small amounts in the bone marrow; if they grow out of control, they invade normal bone marrow and destroy the surrounding bone, producing “holes” called osteolytic lesions or intense diffuse osteoporosis in the bone.

Under normal conditions the plasma cells recognize the foreign antigens and proliferate for a time to produce more antibodies. When the agent disappears, the cell proliferation and antibody production ceases. However, in multiple myeloma, the plasma cells form tumors since they produce antibodies continuously and in large amounts. In this case, the antibodies are called paraproteins or monoclonal components and can be detected in the blood or urine of the patient with multiple myeloma.

Symptoms

Multiple myeloma is initially evident because of pain in the bones that can cause osteolytic lesions or osteoporosis. Sometimes these lesions are detected the first time if there is a bone fracture with minor stress or injury (since the bone is already weak or damaged). Any bone of the organism can be affected but it frequently happens in the back, the limbs, the thorax and the pelvis.

The most severe form is an abrupt compression of vertebrae, with back pain or even symptoms of spinal cord compression.

Multiple myeloma can also cause generalized symptoms such as fatigue (due to lack of red blood cells), appetite loss or weight loss. There can be a reduction in white blood cell count, leading to greater possibilities of infections and a reduction in the number of platelets resulting in abnormal bleeding.

In addition to bone symptoms and other general symptoms, there are also symptoms related to the presence of paraproteins.  This pathologic protein is eliminated by the kidney and, in many cases, is detected when determining the reason for kidney failure. Excessive paraprotein can cause abnormally high viscosity ("thickness") of the blood leading to dizziness, confusion, visual alterations and other neurologic symptoms.

Prevention

There are no preventative measures for multiple myeloma.

Gene or region studied

  • LIG4
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