What are the symptoms of myeloma?

Multiple myeloma can manifest with various symptoms, including bone pain, fatigue and anemia, recurrent infections with fever, renal dysfunction, and bleeding or bruising. As a malignant hematologic disorder, it progressively damages bones, impairs hematopoietic function, and compromises organ function. If persistent bone pain is accompanied by sudden weight loss, recurrent high-grade fever, or other concerning symptoms, prompt medical evaluation and treatment are essential.

1. Bone Pain: Bone pain is a hallmark symptom of multiple myeloma, most commonly affecting the spine (especially lumbar and thoracic regions), ribs, and pelvis. Malignant plasma cells infiltrate and erode bone tissue, leading to decreased bone mineral density; even routine activities or minor mechanical stress may trigger pain. As the disease progresses, pain intensifies and may be associated with structural bone damage and pathologic fractures, significantly impairing mobility and daily functioning.

2. Fatigue and Anemia: Fatigue and anemia typically develop gradually after disease onset. Normal bone marrow hematopoiesis is disrupted, resulting in progressive reduction of red blood cell counts. Patients frequently experience generalized exhaustion, lethargy, and pallor; even mild physical exertion may provoke palpitations and dyspnea. Anemia worsens with disease progression, leading to sustained decline in overall physiological function.

3. Recurrent Infections and Fever: Recurrent infections and fever stem from impaired immune function due to bone marrow involvement, which disrupts normal production of immune cells. Consequently, the body’s ability to combat pathogens diminishes progressively. Patients are prone to frequent infections—particularly of the respiratory and urinary tracts—often accompanied by persistent low-grade fever or recurrent high-grade fever.

4. Renal Dysfunction: Renal impairment commonly results from accumulation of abnormal monoclonal immunoglobulin proteins (e.g., light chains) in the kidneys, increasing metabolic burden and directly damaging renal tubular cells. Clinical signs may include altered urine output and mild peripheral edema. With ongoing disease progression, renal function deteriorates progressively; severe cases may develop overt kidney disease, disrupting systemic metabolic homeostasis.

5. Bleeding and Bruising: Spontaneous bleeding and bruising occur due to thrombocytopenia—reduced platelet production—which impairs coagulation. Patients may notice unexplained petechiae or ecchymoses on the skin. Some experience epistaxis or gingival bleeding without apparent cause; bleeding episodes lack predictable patterns. Even minor trauma may result in prolonged bruising, serving as a visible indicator of coagulopathy.

For daily management: prioritize rest and avoid strenuous physical activity to prevent skeletal injury; maintain balanced nutrition to support overall health; practice diligent infection prevention; monitor key health parameters regularly; and adhere strictly to evidence-based clinical treatment and supportive care protocols.