Light chain multiple myeloma Definition diagnosis and outlook

Light chain multiple myeloma Definition diagnosis and outlook

Light chain multiple myeloma: Definition, diagnosis, and outlook Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is light chain multiple myeloma Medically reviewed by Brett Barlow, MD — By Beth Sissons on May 31, 2022Light chain multiple myeloma is a subtype of multiple myeloma, a cancer of the plasma cells in bone marrow. Multiple myeloma is a rare type of cancer that occurs when plasma cells in bone marrow become cancerous and multiply. There are different types of multiple myeloma, depending on the type of antibody the plasma cells produce. These antibodies, or immunoglobulins, consist of light and heavy chain proteins. Light chain myeloma is a subtype of multiple myeloma, in which the immunoglobulins only consist of light chain proteins. This can affect symptoms, treatment types, and outlook. This article looks at what light and heavy chains are and how light chain myeloma differs from other types of multiple myeloma. What is multiple myeloma Share on PinterestMari Rodriguez/EyeEm/Getty ImagesMultiple myeloma is a rare type of cancer that occurs due to plasma cells becoming cancerous. Plasma cells are a type of white blood cell found in bone marrow, and they help protect against infections. The term for a cancerous plasma cell is a myeloma cell. These cells can multiply, and excessive plasma cells may group together to form a tumor. If there are multiple tumors or the bone marrow contains a significant number of cancerous plasma cells, the condition is called multiple myeloma. Learn more about multiple myeloma here. What are light chains and heavy chains There are different types of multiple myeloma. The type depends on the immunoglobulin that a myeloma cell produces, also known as antibodies or M-proteins. According to the International Myeloma Foundation, immunoglobulins (Ig) usually consist of two heavy chain proteins and two light chain proteins joined together. Myeloma cells produce abnormal immunoglobulins called monoclonal proteins, or M-spike, which cannot fight infection in the same way as regular immunoglobulins. There are five types of heavy chain proteins:IgGIgAIgDIgEIgM There are two types of light chain proteins: kappa and lambda. Light chain proteins are shorter and lighter in weight than heavy chain proteins. Subtypes of myeloma are categorized based on:the type of immunoglobulins they producethe combination of heavy and light chains the immunoglobulin contains The types of immunoglobulins are:IgG kappaIgA kappaIgD kappaIgE kappaIgM kappaIgG lambdaIgA lambdaIgD lambdaIgE lambdaIgM lambda The most common type of myeloma is IgG kappa. This means the myeloma cells produce immunoglobulins made of two IgG heavy chains and two kappa light chains. What is light chain myeloma Roughly 15% of people with multiple myeloma have light chain myeloma. Light chain myeloma occurs when the myeloma cells only produce immunoglobulins with light chain proteins and no heavy chain proteins. According to a 2018 article, changes at a DNA level result in an inability to produce any heavy chains, meaning immunoglobulins only have light chain proteins. People may also refer to light chain myeloma as Bence Jones myeloma after the doctor who discovered this subtype of multiple myeloma. Symptoms The most common symptoms of multiple myeloma are:persistent or frequent bone pain or back painpersistent or worsening fatiguefrequent, unexplained infections, such as sinus infection, pneumonia, or urinary tract infectionswelling in the extremitiesshortness of breath In addition to multiple myeloma symptoms, people with light chain myeloma may also experience:numbness in limbsloss of appetiteimpaired kidney functionexcess calcium in the bloodanemiabone damage A 2018 article found that bone pain and kidney failure are the most common first signs of light chain multiple myeloma. Learn more about the symptoms of multiple myeloma here. How is it diagnosed To diagnose multiple myeloma, doctors will assess any symptoms, take a full medical history, and use a range of tests, including:blood tests to check white and red blood cell countsurine tests to check for elevated levels of M-proteins, as excessive plasma cells can lead to higher levels of M-proteins than usualbone marrow samples to examine plasma cellsimaging scans, such as MRI and CT scans, to look for any changes in the bones These tests can help doctors identify signs that could indicate multiple myeloma, such as:anemiakidney failurebone damage To diagnose the subtype of multiple myeloma and determine whether a person has light chain myeloma, doctors may:test urine or blood for the presence of light chainscheck for deposits of light chains in the kidneys or nerves Light chain multiple myeloma does not create the spike in M-proteins that can be a feature of other types of multiple myeloma, so doctors look for an excess of light chains and the absence of heavy chains. Learn more about multiple myeloma blood tests here. Treatment Treatment for multiple myeloma may include:chemotherapy to decrease the number of myeloma cellsantibiotics to fight infectionpain-relief medicationsradiation therapy to destroy cancer cells or any bone tumorsbiologic drugsintravenous fluids if necessary to prevent dehydration from kidney failurestem cell transplant Treatment may vary depending on a person’s overall health, age, and medical history. According to the Dana-Farber Cancer Institute, doctors usually recommend the following approach to treatment:initial induction phaseintensified treatment, including an autologous stem cell transplant for people who fit certain criteriamaintenance therapytreatment for relapsed disease Doctors often prescribe a VRd drug regimen to treat multiple myeloma. VRd includes:a proteasome inhibitor — Velcadean immunomodulatory agent — Revlimida corticosteroid, such as dexamethasone Learn more about treatment options for multiple myeloma here. A rare but serious complication of light chain multiple myeloma is light chain amyloidosis. This occurs when large quantities of light chain proteins collect in organs. Light chain amyloidosis can affect any organ in the body except the brain, and commonly affects the kidneys and heart. Treatment for light chain amyloidosis may include:diureticsa protein called albuminvasopressors, a type of drug to increase blood pressure to prevent organ damage Learn more about treatment options for multiple myeloma here. Outlook Having light chain myeloma may affect a person’s outlook compared to other types of multiple myeloma. According to a 2021 article, impaired kidney function is more common in light chain multiple myeloma than other types of multiple myeloma. This can result in poorer outcomes. The article notes that bortezomib is an important part of the treatment for managing kidney failure in multiple myeloma. In a long-term follow-up study of 100 people treated with a VRd drug regimen followed by maintenance therapy, the median survival was around 126 months. One older 2014 article notes that early diagnosis and treatment play a vital role in improving outcomes for people with light chain multiple myeloma. If a person has amyloidosis affecting two or more organs, it may also result in a poorer outlook, with an estimated median survival rate of 13 months without treatment. Light chain amyloidosis only occurs in 5–10% of cases. Learn more about the outlook for multiple myeloma here. Summary Multiple myeloma is a cancer of the plasma cells found in bone marrow. Light chain myeloma is a subtype of multiple myeloma. Cancerous plasma cells, or myeloma cells, produce immunoglobulins. These immunoglobulins consist of heavy and light chain proteins. A person has light chain myeloma if the immunoglobulins from myeloma cells only contain light chain proteins. Light chain myeloma can increase the risk of kidney failure and may result in poorer outlooks than other types of multiple myeloma. Early diagnosis and treatment, and a treatment regimen with the drug bortezomib help improve a person’s outlook. Last medically reviewed on May 31, 2022Blood / HematologyCancer / OncologyMedically reviewed by Brett Barlow, MD — By Beth Sissons on May 31, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is a multiple myeloma relapse? People with multiple myeloma, which is a type of blood cancer, may experience relapse after a period during which the condition has improved. Learn…READ MOREDoes multiple myeloma run in families? Multiple myeloma, a type of cancer affecting the blood and bone marrow, has a genetic component. Learn more.READ MOREWhat are the risk factors for multiple myeloma?Medically reviewed by Meredith Goodwin, MD, FAAFP There are many risk factors for multiple myeloma, including a person's age and potential exposure to radiation. Learn more about these factors here.READ MOREWhat to eat if you have multiple myelomaMedically reviewed by Natalie Butler, R.D., L.D. Learn about specific nutrition strategies that can be used to treat common symptoms of multiple myeloma, such as kidney damage and anemia.READ MOREWhat is targeted therapy for multiple myeloma? Targeted therapy can help treat multiple myeloma because it targets the molecules that support the growth of cancer cells.READ MORE
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