Symptoms of multiple myeloma

Multiple myeloma may not cause any signs or symptoms in its early stages. Signs and symptoms often appear once the tumour grows in the bone marrow or somewhere outside of the bone marrow. Signs and symptoms also may appear if the immunoglobulins (M-proteins) build up in organs like the kidney. Other health conditions can cause the same signs and symptoms as multiple myeloma. See your doctor if you have these signs and symptoms.

  • bone pain related to bone fractures that occur most commonly in the back, front of the chest, ribs, hips or skull
  • bone weakness, which can lead to osteoporosis (a condition where bones lose mass, or density, and the bone tissue breaks down)
  • fatigue, weakness, shortness of breath, dizziness and paleness caused by low red blood cell counts (called anemia)
  • frequent infections, including pneumonia (an infection of the lung) related to low white blood cell counts (called neutropenia)
  • fever (related to an infection)
  • nosebleeds, bleeding gums, a lot of bleeding from minor cuts or scrapes or a lot of bruising caused by low platelet counts (called thrombocytopenia)
  • higher than normal levels of protein in the blood or urine
  • extreme thirst, a need to urinate often, dehydration, kidney problems including kidney failure, constipation, loss of appetite, abdominal pain, weakness, drowsiness, confusion, nausea and vomiting or lethargy caused by high levels of calcium in the blood (called hypercalcemia)
  • nervous system problems, including sudden and severe pain, numbness and tingling, muscle weakness, paralysis, confusion and dizziness – some of these symptoms may be related to spinal cord compression, which is a cancer-related emergency
  • weight loss
  • headaches, dizziness, weakness, drowsiness, fatigue, oozing from cuts, blurred vision, bruising, symptoms of a stroke (weakness on one side of the body and slurred speech) caused by a thickening or stickiness of the blood (called hyperviscosity)
  • weakness, shortness of breath, itching and swelling caused by kidney problems

Some of the most common signs and symptoms of multiple myeloma are referred to as CRAB:

  • high blood calcium level (hypercalcemia)
  • kidney problems (renal insufficiency)
  • anemia
  • bone disease

Expert review and references

  • American Cancer Society . Multiple myeloma . Atlanta, GA : American Cancer Society ; 2014 :
  • Dispenzieri A, Lacy MQ, Kumar S . Multiple myeloma. Greer JP, Arber DA, Glader B, List AF, Means RT Jr, Paraskevas F, Rodgers GM, Foerster J, (eds.). Wintrobe's Clinical Hematology. 13th ed. Lippincott Williams & Wilkins; 2014: 98: 2046-2097.
  • Mushi NC, Anderson KC . Plasma cell neoplasms. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 112: 1682-1719.
  • Myeloma Canada. Multiple Myeloma Patient Handbook. Third ed. Kirkland, QC: Myeloma Canada; 2014.
  • National Cancer Institute. Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment PDQ®: Patient Version. National Cancer Institute; 2015:
  • Raje N, Hideshima T, Anderson KC . Plasma cell tuours. Hong WK, Bast RC Jr, Hait WN, et al (eds.). Holland Frei Cancer Medicine. 8th ed. People's Medical Publishing House; 2010: 117: 1668-1685.
  • Rajkumar SV, Kyle RA . Diagnosis and treatment of multiple myeloma. Wiernik PH, Goldman JM, Dutcher JP, Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 33: 637-664.
  • The Leukemia & Lymphoma Society. Myeloma. Revised ed. White Plains, NY: The Leukemia & Lymphoma Society; 2013:

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