Sudden back pain with leg weakness or difficulty passing urine is an emergency. Go to hospital now. This may be spinal cord compression, which is measured in hours. Also seek urgent care for confusion with severe thirst, or fever.
A cancer of plasma cells in the bone marrow. It weakens bones, impairs the kidneys, causes anaemia and raises calcium — and it is now treated as a long-term condition rather than a short illness.
Myeloma is where autologous transplant is standard rather than exceptional. Because the stem cells are the patient's own, it is a considerably safer procedure than a donor transplant, and it remains a routine part of treatment for suitable patients.
Plasma cells normally make antibodies. In myeloma one clone of plasma cells multiplies abnormally in the bone marrow, producing large quantities of a single useless antibody — the paraprotein — while crowding out normal blood production.
The consequences form a recognisable pattern, often remembered as CRAB: raised calcium, renal impairment, anaemia, and bone lesions. The bone disease is characteristic — the abnormal cells activate the cells that break down bone, producing punched-out lesions, fractures through weakened vertebrae, and severe pain.
Kidney impairment is common and partly reversible if treated promptly, caused by light chains from the paraprotein damaging the tubules, sometimes compounded by dehydration, high calcium and anti-inflammatory painkillers.
Myeloma is not currently curable in most patients, but treatment has changed enormously. Sequences of highly effective drug combinations, autologous transplant in suitable patients, and maintenance therapy have turned it into a condition many people live with for many years.
Myeloma weakens the vertebrae, and a collapsing vertebra or a mass of plasma cells can press on the spinal cord. The warning signs are new or worsening back pain with weakness in the legs, numbness in a band around the trunk, or difficulty passing urine. Once the cord is damaged the deficit is frequently permanent, and treatment is measured in hours. This needs an urgent MRI and immediate steroids and radiotherapy or surgery — at the nearest hospital, not after arranging travel.
Blood and urine protein studies, plus imaging of the whole skeleton.
Cytogenetic abnormalities identified by FISH on the marrow sample separate standard-risk from high-risk myeloma, and that distinction affects treatment intensity, the role of transplant and the realistic outlook. Send the marrow report with cytogenetics, the paraprotein and light chain levels, calcium and kidney function, and the imaging report. Also send the details of any treatment already given and the response to it.
Treatment is a sequence rather than a single intervention.
A combination of drugs — typically a proteasome inhibitor, an immunomodulatory drug and a steroid, increasingly with an antibody added — given over several months to reduce the disease substantially before transplant. Much of this can be given near your home once the regimen is set.
Your own stem cells are collected, high-dose chemotherapy clears the marrow, and the cells are returned. Because they are your own there is no rejection and no graft-versus-host disease, making this far less hazardous than a donor transplant. It deepens the response and lengthens the time before the disease returns.
Continuing a single drug at low dose after transplant, usually for years, to delay relapse. It is taken at home and is one of the clearest advances in myeloma management over the past decade.
Bisphosphonates or denosumab to protect the skeleton and reduce fractures, radiotherapy for painful lesions or cord compression, surgery to stabilise a threatened bone, careful attention to hydration and avoidance of anti-inflammatory painkillers, and vaccination and prompt treatment of infection.
Age matters less than general fitness and organ function. Many patients in their sixties and seventies are suitable.
High-risk abnormalities shift the treatment towards more intensive and more prolonged regimens.
Significant kidney impairment affects drug choice and doses, and treating the myeloma promptly is what recovers kidney function.
Much of myeloma treatment is drug therapy given over months, and most of it can be given near your home. What is genuinely worth travelling for is the transplant itself and a properly constructed plan.
Spinal cord compression and very high calcium are emergencies treated where you are, immediately. Both are common in myeloma and both are frequently recognised late.
Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.
Your own stem cells are collected from the blood, stored, and returned after high-dose chemotherapy has cleared the marrow. Because the cells are your own there is no rejection and no graft-versus-host disease, which makes it considerably safer than a donor transplant. It is a standard part of myeloma treatment rather than a last resort.
Probably not. Fitness matters far more than the number, and many patients in their sixties and seventies undergo autologous transplant successfully. The assessment looks at heart, lung and kidney function and general performance status. Send your reports and we will give you an honest view rather than an age-based rule.
In most patients it is not currently cured, but it is now treated as a long-term condition. Sequences of highly effective drugs, transplant and maintenance therapy have extended survival substantially, and many patients live for many years with good quality of life. A small proportion achieve very durable remissions.
No. Induction therapy over several months can usually be given near your home once the regimen is set, and maintenance is tablets taken at home. What is worth travelling for is stem cell collection and the transplant itself, plus a properly constructed treatment plan. We will map out which parts need to be here.
Myeloma activates the cells that break down bone, producing weakened areas and fractures, particularly through the vertebrae. Pain control, bisphosphonates to protect the skeleton, radiotherapy to painful lesions and sometimes surgical stabilisation are all part of treatment. New back pain with leg weakness is an emergency and needs immediate assessment.
Frequently, at least partially, if the myeloma is treated promptly. Kidney damage is largely caused by light chains from the paraprotein, so reducing the paraprotein quickly is the treatment. Good hydration and avoiding anti-inflammatory painkillers and contrast scans where possible also matter considerably.
Send the bone marrow report with cytogenetics, your paraprotein and light chain levels, and kidney function. Tell us what treatment has already been given and how well it worked.
Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.
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Coordinators available 9:00–20:00 IST. We speak Arabic, English, Russian and Bengali.