Blood Cancer Warning: Why Indians Must Wake Up To The Threat Of Multiple Myeloma
Multiple myeloma is a type of blood cancer that affects plasma cells, a kind of white blood cell found in the bone marrow. Plasma cells create immunoglobulins – a type of antibodies that help the body fight infections. In multiple myeloma, these cells become cancerous and multiply uncontrollably.
According to Massachusetts General Hospital, the earlier that multiple myeloma is detected, the better the patient's prognosis. In general, the patient’s prognosis will depend on the stage of the disease, how aggressive the form of cancer is, his/her age and general health.
According to Harvard Health, treatment of multiple myeloma is sometimes delayed until symptoms appear. When treatment begins, it can include:
- Chemotherapy
- Bortezomib (Velcade)
- Bisphosphonates
- Immunoglobulins
- Thalidomide or lenalidomide
- Radiation therapy
- Stem cell transplant
Harvard Health adds that while none of these therapies provide a cure, they can, however, control the disease or delay its return for years. In short, Multiple Myeloma is treatable, though not curable.
Dr. Nitin Agarwal told ABP Live that several Asian countries, including India, have seen a sudden and unprecedented rise in cases of Multiple Myeloma, signifying the urgent need for greater awareness and healthcare response strategies. Dr. Nitin Agarwal is an MD in Transfusion Medicine, and HoD, Donor Request Management, DKMS BMST Foundation India.
DKMS BMST Foundation India is a non-profit working to combat blood cancers (like leukaemia), thalassemia, aplastic anaemia, and other blood disorders by promoting and facilitating blood stem cell (bone marrow) transplants. Its core missions include:
- Raising Awareness & Donor Registry Building
- Facilitating Donor Matching & Transplants
- Financial & Patient Support
- Partnership with hospitals and Education/Building Awareness.
The endeavour has apparently paid off as DKMS has built a registry of over 70,000 eligible and willing stem-cell donors in India, 28–29 life-saving transplants, and more than 1,300 registration drives — plus numerous awareness campaigns.
Here are excerpts from the interview with Dr. Nitin Agarwal.
ABP Live: How prevalent is multiple myeloma in India? What age group does it affect the most?
Dr. Nitin Agarwal: The incidence of multiple myeloma in India accounts for approximately 1.19% of all cancer cases. The crude incidence rate is 1.27 per 100,000 men and 0.95 per 100,000 women. The age-adjusted rates are 1.13 and 0.81 per 100,000 for men and women, respectively. The incidence rises with age, with most cases occurring in individuals aged 60-69. Simply put, it’s more common in people over 60, and men are slightly more at risk than women.
ABP Live: How does the Indian population’s genetic predisposition or environmental factors influence the risk of developing myeloma?
Dr. Nitin Agarwal: The exact cause remains unclear, but research suggests potential links to genetic mutations and environmental factors such as exposure to harmful radiation and certain chemicals such as pesticides, heavy metals, and industrial pollutants, have also been noted as potential risk factors. Chronic inflammatory diseases and obesity can increase the risk of developing the disease.
ABP Live: What are some early warning signs of multiple myeloma that often go unnoticed, and how can awareness be improved among the general public and primary care physicians?
Dr. Nitin Agarwal: The early stages of multiple myeloma may not show any noticeable signs or symptoms. But blood tests can report signs of the conditions. Also, as the disease progresses, individuals might experience the following:
- Anaemia
- Recurring infections like pneumonia
- Thrombocytopenia
- Bone Pain and fracture
- Kidney damage
- Amyloidosis
- Hypercalcemia
- Hyper-viscosity Syndrome
- Cryoglobulinemia
- Extreme thirst leading to drinking a lot of fluids and frequent urination
ABP Live: Are there any known risk factors—such as lifestyle, diet, or occupational hazards—that increase the likelihood of multiple myeloma in Indians?
Dr. Nitin Agarwal: Obesity, smoking and consumption of highly processed foods may elevate the risk of developing multiple myeloma. Additionally, occupational exposure in certain industries can also play a role.
ABP Live: How accessible is early detection of multiple myeloma in India, and what are the key diagnostic challenges faced in different healthcare settings (urban vs. rural)?
Dr. Nitin Agarwal: In rural areas, access to healthcare remains a significant challenge. Key diagnostic barriers can be lack of awareness about the disease, insufficient screening programmes, dearth of advanced diagnostic facilities like cytogenetic testing or specialised care, and the rural population often relying on general practitioners with limited resources for haematological assessment.
ABP Live: What are the current standard treatment options available for multiple myeloma in India, and how do they compare to global treatment protocols?
Dr. Nitin Agarwal: Immunomodulatory drugs (e.g., thalidomide, lenalidomide), proteasome inhibitors (e.g., bortezomib), and alkylating agents (e.g., melphalan). Access and affordability to these may vary.
ABP Live: What role does blood stem cell transplantation play in treating multiple myeloma, and how feasible is it for Indian patients in terms of cost and availability?
Dr. Nitin Agarwal: Autologous stem cell transplants are the choice for Multiple Myeloma, and Allogenic transplants are only used in a few cases, like refractory myeloma after primary transplant.
ABP Live: How has stem cell donor registration evolved in India, and what initiatives is DKMS undertaking to improve donor availability for myeloma patients?
Dr. Nitin Agarwal: DKMS Foundation India plays a vital role in expanding donor registries by collaborating with corporations and educational institutions. Through customised corporate social responsibility (CSR) initiatives, the foundation promotes donor registration drives and encourages volunteering within employee wellness programs.
DKMS recruits young donors linked to higher transplant success rates by targeting universities and colleges, organising awareness programmes and blood stem cell registration camps. Additionally, partnerships with medical institutions offer incentives, while engaging student unions and influencers ensures sustained involvement. These efforts enhance donor registrations and foster long-term commitment to the cause, positively impacting patients needing transplants nationwide.
Kirti Pandey is a senior independent writer.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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