What is the First Sign of Multiple Myeloma


Bone marrow is a soft, fatty tissue present within the bones of the body. It plays a crucial role in producing blood cells and platelets. Multiple myeloma is a relatively rare type of cancer that originates in specific white blood cells called plasma cells, which are found in the bone marrow. When cancerous plasma cells (known as myeloma cells) develop and accumulate in the bone marrow, they can disrupt the normal production of healthy red blood cells, white blood cells, and platelets.

Furthermore, multiple myeloma can heighten the activity of bone-breaking cells called osteoclasts while reducing the activity of bone-building cells called osteoblasts. Consequently, the degradation of existing bone can eventually surpass the formation of new bone.

Symptoms of multiple myeloma

The symptoms of multiple myeloma typically emerge gradually and may not become evident until the disease reaches an advanced stage. The primary indicator of multiple myeloma is bone pain, particularly affecting the spine and ribs.

Early manifestations of multiple myeloma comprise:



Loss of appetite



Frequent infections

Excessive thirst

Unintentional weight loss

Symptoms associated with end-stage multiple myeloma are commonly referred to as CRAB symptoms, which encompass:

C – Elevated blood calcium levels

R – Renal (kidney) dysfunction

A – Anaemia

B – Bone lesions

What is the first sign of multiple myeloma?

In its initial stages, multiple myeloma may not manifest noticeable symptoms. Often, this condition is detected incidentally during routine urinalysis or unrelated blood tests. As the disease advances, the abnormal myeloma cells can surpass the healthy blood cells in number, causing disruption in their functioning and giving rise to various health complications.

What health conditions can happen with multiple myeloma?

Abnormal cellular activity in the bone marrow can trigger a series of medical complications, including:


Anemia is often an early sign of multiple myeloma. The interference of myeloma cells with the production of healthy blood cells in the bone marrow can result in a shortage of red blood cells. Symptoms of anaemia include shortness of breath, exhaustion, headache, dizziness, and leg swelling.


Multiple myeloma can cause a deficiency of infection-fighting white blood cells, known as leukopenia. This condition can lead to frequent infections and symptoms such as fever, chills, and excessive sweating.


Multiple myeloma can also cause a low platelet count, leading to symptoms such as easy bruising, petechiae (small reddish spots on the skin), chronic nosebleeds, bleeding gums, and blood-tinged urine or stool.

Spleen enlargement 

Myeloma can contribute to the enlargement of the spleen.


Due to the accelerated bone resorption associated with multiple myeloma, high levels of calcium in the blood, known as hypercalcemia, can occur. Symptoms of hypercalcemia include nausea, vomiting, loss of appetite, increased thirst, frequent urination, constipation, muscle weakness, and twitching.

Hyperviscosity syndrome 

Abnormal proteins produced by myeloma cells, such as M-proteins, can cause the blood to become thick and sticky. Hyperviscosity syndrome symptoms comprise headaches, chronic nosebleeds, easy bruising, gastrointestinal bleeding, profound fatigue, and vision issues.


Myeloma cells can produce cryoglobulins, abnormal proteins that thicken or gel in cold temperatures. Cryoglobulinemia symptoms encompass joint pain (arthralgia), pain and numbness in fingers and toes due to cold exposure (Raynaud’s syndrome), and the appearance of purple spots on the skin and mucous membranes (purpura), and weakness.


Myeloma cells may produce extra fragments of antibodies called monoclonal light chains, which can accumulate and interfere with the function of various organs, nerves, and tissues in the body. This condition is known as amyloidosis and can affect organs such as the heart, kidneys, skin, and tongue.

Renal failure

The buildup of light chains in the kidneys can impair their function and lead to renal failure. Symptoms of renal failure include decreased urine output, leg and ankle swelling, shortness of breath, fatigue, confusion, nausea, weakness, irregular heartbeat, and chest pain or pressure.

When to See a Doctor?

If you have persistent bone pain, unexplained fatigue and weakness, recurring infections, or any other concerning symptoms, it is important to seek medical attention. Consulting a healthcare professional will allow for proper evaluation and diagnosis, especially if you suspect you may have multiple myeloma.


In conclusion, understanding what is the first sign of multiple myeloma is crucial for early detection and timely medical intervention. Recognizing symptoms like persistent bone pain, fatigue, or unexplained weight loss can lead to prompt diagnosis, ensuring a better chance of successful treatment and improved quality of life. Stay vigilant about your health, and if you experience any of these potential indicators, consult a healthcare professional for proper evaluation and guidance.


Q1: What are the common risk factors for multiple myeloma?

Ans: Common risk factors include age, family history, male gender, and certain genetic factors.

Q2: Can multiple myeloma be cured?

Ans: While there is no known cure for multiple myeloma, treatment options can help manage the disease and improve quality of life.

Q3: What are the treatment options for multiple myeloma?

Ans: Treatment options may include chemotherapy, targeted therapies, stem cell transplant, radiation therapy, and supportive care.

Q4: How is multiple myeloma diagnosed?

Ans: Diagnosis involves a combination of blood tests, urine tests, bone marrow biopsy, imaging tests, and genetic analysis.

Q5: What is the prognosis for multiple myeloma?

Ans: Prognosis varies depending on various factors, including the stage at diagnosis, overall health, and response to treatment.


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