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Myeloma Treatment in Ghaziabad

Myeloma is one of those types of blood cancer that patients do not readily identify when they are diagnosed because there is no lump, there is no visible tumor detected on a scan, and its warning signs such as bone pain, fatigue, and repeated infections are very similar to many other illnesses. This type of cancer also underwent a tremendous transformation in terms of treatment options during the last ten years, as a result of which life expectancy improved significantly. 

In this guide, we will discuss what myeloma is, what MGUS is, why you have probably heard this term related to the blood test, what the symptoms of myeloma are, and how it is treated now – from chemotherapy to stem cell transplant and even CAR T-cell therapy – with all stages of treatment available in Ghaziabad, at Yashoda Medicity.

What Is Multiple Myeloma?  

Multiple myeloma is a cancer that affects plasma cells, which are a type of white blood cell responsible for producing antibodies that fight infections. In multiple myeloma, there is uncontrolled proliferation of abnormal plasma cells in the bone marrow, which inhibits the production of other blood cells and produces large amounts of a specific, useless antibody, also referred to as the M-protein or paraprotein. The prefix “multiple” is used in the term because this disease occurs in more than one place in the skeletal system.

MGUS: The Precursor Condition  

MGUS stands for Monoclonal Gammopathy of Undetermined Significance, and it is a separate, though related, disorder that you should be well aware of if you have heard about it in a blood test result. MGUS is an abnormal presence of plasma cells and M-proteins in the bloodstream, with numbers insufficient for a diagnosis of myeloma, and no organ damage.

The main thing to remember about MGUS symptoms is that there are virtually none because of the way this disorder is defined – MGUS is diagnosed incidentally during an examination performed for some other purpose that reveals abnormal protein content in the blood. There is a risk of developing multiple myeloma over a long period of time (about 1% per year), which is why MGUS is managed through routine checks but not treatment.

Multiple Myeloma Symptoms  

The signs of myeloma may be recalled by the mnemonic “CRAB” – the four major organs affected that together with blood and marrow abnormalities help make the diagnosis of active myeloma, which requires treatment:

  • Calcium (high): The breaking down of bones leads to the release of calcium in the blood, causing fatigue, confusion, constipation, and excessive thirst
  • Renal failure: The abnormal proteins that myeloma cells produce cause harm to the kidneys, which can manifest as decreased urination or decreased renal function on blood tests
  • Anemia: The presence of myeloma cells decreases red blood cell production, resulting in fatigue, pallor, and shortness of breath
  • Bone lesions: Myeloma is known to have lesions or destruction of bones locally, giving rise to bone pain (particularly in the back and ribs) and, in some instances, fractures due to minimal trauma 

Aside from the aforementioned manifestations, other common symptoms of multiple myeloma include recurrent infections (as there is decreased antibody production), generalized fatigue, and in some patients, peripheral neuropathy, or in rare instances spinal cord compression from vertebral fractures.

Diagnosing Myeloma 

  • Blood tests:  Serum Protein Electrophoresis and Free Light Chain Assay for detecting and quantifying the abnormal M-protein, in addition to calcium, renal function, and complete blood count
  • Urine tests: For detecting the presence of Bence-Jones protein, which is an abnormal protein found in the urine of patients with myeloma
  • Bone marrow biopsy: To confirm and quantify the percentage of abnormal plasma cells in the bone marrow
  • Imaging: Whole body low dose CT, MRI or PET-CT for detecting lytic bone lesions and disease extent, usually superior to old style Skeletal Survey X-Rays due to their increased sensitivity 
  • Cytogenetics/FISH:  Detects specific genetic abnormalities within the myeloma cells, which can be used to determine the risk group

Myeloma Treatment  

There have been many changes in the treatment of myeloma in the last ten years because there are different "novel agents," including proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies, which are currently at the core of most treatment regimens and which are used along with steroid therapy and even with stem cell transplantation where possible. It is very important to note that myeloma is considered a chronic disease that requires long-term management with many lines of therapy rather than one-time cure, and this is something to understand at an early stage.

Chemotherapy For Multiple Myeloma

Cytotoxic chemotherapy remains relevant in myeloma therapy, especially high-dose melphalan administration as a conditioning regimen before the autologous stem cell transplant. In terms of induction therapy, current regimens typically consist of a proteasome inhibitor (bortezomib), an immunomodulatory agent (lenalidomide), and dexamethasone, which may be supplemented with a monoclonal antibody in eligible patients, rather than conventional chemotherapy. The type and intensity of the combination are determined by the patient’s general fitness, renal function, cytogenetic risk group, and intention to proceed with a stem cell transplant.

Stem Cell Transplant For Multiple Myeloma  

Autologous stem cell transplant, which entails the use of a patient’s previous stem cells collected from him/her in the past, still forms a significant component of treatment in eligible patients after induction therapy. 

This approach requires collection (harvesting) of the patient’s own stem cells in advance, administration of high doses of melphalan chemotherapy to destroy any remaining myeloma, and reinfusion of the previously collected stem cells to restore normal bone marrow function. Although this approach alone does not constitute a cure, it significantly improves remission and helps maintain disease control compared with undergoing only induction therapy, and is usually followed by maintenance therapy. Not all patients are ideal candidates for this procedure; various health-related issues come into play here.

CAR T-Cell Therapy For Multiple Myeloma  

CAR T-cell therapy constitutes one of the most important innovations in myeloma treatment in recent times. This therapy collects the patient's own T-cells (which are a kind of immune cell), modifies them in specialized labs so that they recognize and kill the myeloma cells (usually by using an antigen known as BCMA, which is present in myeloma cells), and infuses them back into the patient's body. The therapy is primarily used in cases of relapsed or refractory myeloma, i.e., myeloma that either has relapsed despite multiple treatments or has become resistant to various treatments, and has proved capable of producing profound and even durable responses in carefully selected patients when other treatments have failed. This is a sophisticated, resource-heavy therapy that requires a specialized lab setup, which is precisely what we can offer at our Cell and Gene Therapy Lab.

Living With Myeloma: Maintenance & Supportive Care  

  • Maintenance therapy: Typically a lower-intensity, ongoing medication (commonly lenalidomide) after induction treatment or transplant, aimed at prolonging remission 
  • Bone-strengthening treatment: Bisphosphonates or denosumab, used to reduce the risk of further fractures and manage bone-related complications 
  • Radiation therapy: For localized, painful bone lesions, spinal cord compression, or where a specific skeletal area needs targeted control. To deliver maximum precision while sparing healthy tissue, advanced systems such as Varian ETHOS with HYPERSIGHT and IDENTIFY Technology, Varian EDGE with HyperArc and Brainlab ExacTrac Dynamic, Elekta Unity MR-Linac, and Varian Bravos high-dose-rate brachytherapy platforms are utilized when targeted radiation is indicated. 
  • Kidney and infection monitoring: Ongoing surveillance given myeloma's characteristic effects on kidney function and immune defence 
  • Regular monitoring for relapse: Since myeloma typically follows a pattern of remission and eventual relapse, requiring a new line of treatment when it recurs 
  • Hemato-Oncology led by Dr. Nivedita Dhingra, Director & Head of Hematology, Hemato-Oncology and Bone Marrow Transplant (Adult & Paediatric), with Dr. Karuna Jha, Senior Consultant 
  • Full diagnostic pathway on-site: Serum/urine protein studies, bone marrow biopsy, and cytogenetic/FISH testing for accurate risk stratification 

Book a Consultation

Should there be any anomaly in your protein levels that a blood test indicates, or do you have bone pains, fatigue, frequent infections, or kidney issues? The early haematological evaluation will help you get a clear picture of what is really happening and ensure all your treatment options remain open. To schedule an appointment with our Hematology-Oncology specialists at Yashoda Medicity, Ghaziabad, call +91 9266610101.

Yashoda Medicity: Yashoda Medicity, Hospital Plot, Shakti Khand 2, Indirapuram, Ghaziabad, Uttar Pradesh - 201014  |  Phone: +91 9266610101

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Dr. Jigar Paghadar
Dr. Jigar Paghadar

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Dr. Nikhil Tandon
Dr. Nikhil Tandon

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Dr. Nishtha Sachdeva
Dr. Nishtha Sachdeva

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Dr. Manish Singhal
Dr. Manish Singhal

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Dr. Nivedita Dhingra
Dr. Nivedita Dhingra

Director & Head

Dr. Karuna Jha
Dr. Karuna Jha

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Dr. Hemlata Garg
Dr. Hemlata Garg

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Dr. Ipshita Sahoo
Dr. Ipshita Sahoo

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Dr. Satinder Kaur
Dr. Satinder Kaur

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Dr. Abhishek Yadav
Dr. Abhishek Yadav

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Dr. Gagan Saini

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Dr. Rashmi Shukla

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Frequently Asked Questions

No. Most people with MGUS do not develop multiple myeloma. The average risk of progression is approximately 1% per year, although individual risk varies. This is why MGUS is generally monitored regularly with blood tests and clinical follow-up rather than treated immediately.

Yes. Multiple myeloma is treatable and is often managed as a chronic condition using different therapies over time. Advances in treatment, including targeted therapies, immunotherapies, stem cell transplantation, and CAR T-cell therapy for eligible patients, have improved disease control and outcomes.

Eligibility for stem cell transplantation depends on factors such as the patient's overall health, fitness, organ function, disease characteristics, and response to initial treatment. A haematologist evaluates these factors to determine whether transplantation should be included in the treatment plan.

CAR T-cell therapy may be considered for eligible patients with multiple myeloma based on prior treatments, response to therapy, disease characteristics, and applicable treatment protocols. A haematologist or cellular therapy specialist determines whether CAR T-cell therapy is appropriate for an individual patient.

Possible signs of multiple myeloma include persistent bone pain, particularly in the spine or ribs, fatigue, recurrent infections, and abnormalities in blood tests such as anaemia, elevated calcium levels, or impaired kidney function. These findings require medical evaluation because they can also occur with other conditions.

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