How is multiple myeloma treated?

     Multiple myeloma (MM) is a malignant tumor in which plasma cells proliferate clonally. There is clonal proliferation of plasma cells (or myeloma cells) in the bone marrow, causing osteolytic bone destruction, the appearance of monoclonal immunoglobulins in the serum, inhibition of normal polyclonal immunoglobulin synthesis, and the appearance of periprotein in the urine, which finally leads to anemia and renal impairment. The incidence of myeloma in China is about 1 per 100,000, which is lower than that in western industrialized countries. The age of onset is mostly between 50 and 60 years old, but less than 40 years old, and the ratio of men to women is 3:2. The cause of onset is not clear.  Clinical manifestations: bone destruction (bone pain, fractures, bead-like nodules at the junction of the chest, ribs and clavicle are characteristic of the disease), infection, hyperviscosity syndrome (dizziness, vertigo, blurred vision, tinnitus, and sudden onset of impaired consciousness, numbness of fingers, etc.), bleeding, renal impairment (proteinuria, tubular urine and even acute renal failure).   Diagnosis: plasma cells >15% in bone marrow with abnormal morphology; large amount of M protein in serum or protein of the week >1g/24h in urine; osteolytic lesions or extensive osteoporosis.  Western medical treatment : 1, chemotherapy: MP program can be used for primary cases, if it is ineffective or relapses after remission, it should be used as a refractory case with VAD or M2 program.  2.Thalidomide (reaction stop): 50-600mg, divided into 2-3 oral doses, is effective for some patients with myeloma.  3.Inhibit bone destruction: commonly used are pamidronate disodium 60-90mg intravenous drip per month, which can reduce pain and some can show bone repair.  4.Hematopoietic stem cell transplantation: allogeneic hematopoietic stem cell transplantation and own peripheral hematopoietic stem cell transplantation.  Chinese medicine treatment: This disease belongs to the category of “back pain”, “bone paralysis” and “deficiency labor” in Chinese medicine. According to the theory of TCM combined with modern medical understanding, our treatment is to benefit the qi, tonify the kidney, activate blood circulation, detoxify and anti-cancer.  Prognosis : Treatment with MP protocol can control the growth of myeloma and prolong the course of the disease from 6-12 months to about 3 years. The myeloma cells may expand rapidly and the disease may deteriorate rapidly; or it may develop into myelodysplastic syndrome or acute myeloid leukemia due to bone marrow failure caused by repeated use of alkylating agents. Approximately 5% of patients treated with the MP regimen can achieve complete remission, meaning that M protein cannot be detected and the bone marrow returns to normal. The remission period usually does not exceed 18 months, and survival is approximately 30-36 months. Patients with low tumor load and a good response to treatment with MP regimens also account for about 5% and have a survival of 10-15 years.