Myeloma A comprehensive guide

This is Myeloma Australia’s patient guide (5th edition, 2023) covering all aspects of living with myeloma, a blood cancer affecting plasma cells in the bone marrow. Around 2,700 Australians are diagnosed annually, mostly over age 60.

The guide explains that myeloma develops from a precursor condition called MGUS, where only about 1% of cases progress to myeloma each year. It’s classified by the type of abnormal immunoglobulin (paraprotein) produced, with IgG being most common at 65%.

Key symptoms use the CRAB acronym: Calcium elevation, Renal insufficiency, Anaemia, and Bone involvement. Other symptoms include fatigue, recurrent infections, and peripheral neuropathy.

Diagnosis involves blood tests (paraprotein levels, full blood count), urine tests, imaging (CT, PET/CT, MRI), and bone marrow biopsies. Staging uses the Revised International Staging System (R-ISS).

Treatment is highly individualised, using combinations of medicines including immunomodulators (like lenalidomide), proteasome inhibitors (like bortezomib), monoclonal antibodies (like daratumumab), steroids, chemotherapy, and newer therapies like CAR T-cell therapy.

Eligible patients (generally under 70) may receive autologous stem cell transplants. Myeloma is a relapsing-remitting cancer — it responds to treatment but eventually returns, requiring different therapies over time.

The guide emphasises self-care: balanced nutrition, safe exercise, fatigue management, emotional wellbeing, and sleep hygiene. It covers practical support including financial assistance through Medicare Safety Nets, PBS Safety Nets, and Centrelink, plus guidance on workplace rights, advance care planning, and carer support.