Bone pain. A large number of patients suffer from bone pain, particularly in the back, hip, ribs, pelvis or skull. Either all bones throughout the body may suffer weakness (osteoporosis), which increases the risk of fractures, or only those located in the area of the malignant plasma cell tumour (plasmocytoma).
Low red blood cell count (anaemia). Patients with anaemia have a reduced number of red blood cells. Signs of anaemia are weakness, tiredness and difficulty to exert oneself.
Leukopaenia. A lack of white blood cells which means the body is more exposed to infections. Leukopaenia is less frequent than anaemia.
Thrombocytopaenia. A reduced number of platelets in the blood which can lead to bleeding (nosebleeds, scratches and cuts or small bruises, could result in heavy bleeding and women experience an increase in menstrual flow). Thrombocytopaenia is a lot less common than anaemia.
Hypercalcaemia. Hypercalcaemia is an increase in calcium levels in the blood due to bone damage. It can cause weakness, drowsiness and confusion, as well as severe constipation, abdominal pain, loss of appetite, extreme thirst and a constant need to urinate, which may also produce dehydration and even kidney failure and confusion. If calcium levels are very high, it can even lead to a state of coma.
Recurrent infections. Pneumonia and other respiratory tract infections are common in the early stages of multiple myeloma due to the decrease in antibodies protecting against these infections.
Fractures. Bones sometimes break on their own or due to minor efforts or injuries because they are already weakened by the disease. Fractures occasionally occur in spinal vertebrae, producing intense back pain and maybe even affecting the spinal cord.
Kidney problems. The myeloma protein (kappa or lambda light chains) can damage the kidneys. It does not produce any symptoms at first but any signs of kidney damage can be detected through a blood or urine test.