Oncology
Multiple Myeloma
다발성골수종
Plasma cell malignancy with CRAB features
- How common
- A measurable share of cancer diagnoses
- Typical age
- Variable age
What is it?
Multiple Myeloma arises from accumulated driver mutations and altered tumor microenvironment.
Commonly affected: bone marrow and distant metastatic sites
How it develops
- Initiating eventExposure to risk factors (연령·MGUS)
- Aberrant growthClonal expansion in bone marrow
- Local invasionBasement membrane breach, neoangiogenesis
- Lymphatic & distant metastasisSpread to lymph nodes and distant organs
Symptoms
- Local symptomsSite-specific signs of Multiple Myeloma
- Weight loss/anorexiaCachexia is common
- Fatigue/astheniaCommon in advanced disease
- LymphadenopathyRegional or distant nodes
How it is examined
- Staging assessmentApply TNM or disease-specific staging
- PS/comorbiditiesECOG PS, nutrition, comorbidities
Imaging
CXR/AXR to screen for obvious metastases.
- Metastatic nodules
- Lymphadenopathy
CT/MRI/PET-CT for precise staging + tissue biopsy.
- Primary tumor
- Nodal involvement
- Distant metastasis
Non-surgical care
- Multidisciplinary tumor boardMed-onc, surgery, RT, pathology
- ChemotherapyDisease-specific standard regimens
- Targeted/immunotherapyTargeted/IO based on molecular markers
- Palliative/supportive careSymptom control, nutrition, psychosocial, hospice
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Resectable localized tumor or palliation of complications
Procedures that may be discussed
- Curative resection + lymphadenectomy
- Neoadjuvant/adjuvant chemoRT combination
- Palliative surgery (obstruction/bleeding)
Outlook
Varies by stage, molecular subtype, treatment response.