Last reviewed: March 2026 | Written by Dr. Ekta Vala Chandarana, Medical Oncologist & Hemato-Oncologist, Medisquare Superspeciality Hospital, Ahmedabad
Multiple Myeloma is a cancer of the plasma cells – a type of white blood cell found in the bone marrow that normally helps your body fight infections. In Multiple Myeloma, these plasma cells grow uncontrollably, crowding out healthy blood cells and producing abnormal proteins that can damage the kidneys, bones, and immune system.
In India, Multiple Myeloma accounts for approximately 10–15% of all blood cancers and its incidence is rising. It most commonly affects people above the age of 50, though younger patients are increasingly being diagnosed. The good news and this is something I tell every patient and family who comes to our Hospital in Ahmedabad is that Multiple Myeloma is a treatable condition. With the right treatment protocol, many patients go on to live active, fulfilling lives for years after diagnosis.
This guide covers everything you need to know about Multiple Myeloma from early warning signs and how it is diagnosed to the full range of treatment options available in India and Ahmedabad today.
Symptoms of Multiple Myeloma – Early Warning Signs to Watch For
One of the challenges with Multiple Myeloma is that it often has no symptoms in its earliest stages. Many patients are diagnosed incidentally when a routine blood test shows abnormal results. However, as the disease progresses, the following symptoms typically appear:
CRAB – the key symptom framework
CRAB is the medical acronym doctors use to identify the main complications of Multiple Myeloma:
- C – Calcium elevation (hypercalcaemia): Myeloma causes bones to release excess calcium into the blood, leading to excessive thirst, frequent urination, nausea, confusion, and constipation
- R – Renal (kidney) impairment: Abnormal proteins produced by myeloma cells can clog and damage the kidneys, causing fatigue, swelling, and reduced urine output
- A – Anaemia: Myeloma cells crowd out red blood cell production in the bone marrow, causing persistent fatigue, weakness, shortness of breath, and pallor
- B – Bone disease: Myeloma weakens bones, causing deep bone pain (especially in the back, hips, and ribs), fractures without significant injury, and spinal compression
Other symptoms to watch for
- Persistent fatigue that does not improve with rest
- Frequent infections – particularly pneumonia or urinary tract infections
- Unexplained weight loss
- Numbness or tingling in hands and feet (peripheral neuropathy)
- Back pain that is new, persistent, or worsening – especially in older adults
- Repeated fractures or bone pain without clear cause
Important: These symptoms can also be caused by other conditions. If you or a family member is experiencing two or more of these symptoms especially unexplained back pain, fatigue, and frequent infections together please consult a haematologist or medical oncologist in Ahmedabad for evaluation.
How is Multiple Myeloma Diagnosed?
Diagnosing Multiple Myeloma involves a combination of blood tests, urine tests, imaging, and bone marrow biopsy. At our oncology practice in Ahmedabad, we follow international diagnostic guidelines to ensure accurate staging before any treatment decision is made.
Blood tests
- Complete Blood Count (CBC) – checks for anaemia and low platelet count
- Serum Protein Electrophoresis (SPEP) – detects the abnormal M-protein produced by myeloma cells
- Serum Free Light Chain assay – measures kappa and lambda light chains
- Beta-2 microglobulin and albumin – used for staging
- Kidney function tests (creatinine, eGFR) and calcium levels
Urine tests
- 24-hour urine protein electrophoresis detects Bence Jones proteins, a hallmark of Myeloma
Imaging
- Whole-body PET-CT scan preferred for detecting bone lesions
- MRI of spine essential if spinal compression is suspected
- X-rays of long bones may show characteristic ‘punched out’ lytic lesions
Bone marrow biopsy
This is the definitive test for Multiple Myeloma. A small sample of bone marrow, usually taken from the back of the hip bone is examined under a microscope. A diagnosis of Multiple Myeloma requires ≥10% clonal plasma cells in the bone marrow, along with evidence of organ damage (CRAB criteria) or specific high-risk biomarkers.
Cytogenetic testing of the biopsy sample (FISH testing) also reveals the genetic subtype of the Myeloma, which directly guides treatment choice particularly for high-risk subtypes such as del(17p), t(4;14), or t(14;16).
Stages of Multiple Myeloma – The Revised ISS Staging System
Multiple Myeloma is staged using the Revised International Staging System (R-ISS), which uses blood markers to categorise disease severity. Understanding your stage helps your oncologist plan the most effective treatment.
| Stage | What it means | Key marker |
| Stage 1 | Early stage. Cancer cells present but limited spread. Patient usually feels well. | Beta-2 microglobulin < 3.5 mg/L |
| Stage 2 | Intermediate stage. More active disease than Stage 1. | Between Stage 1 and Stage 3 markers |
| Stage 3 | Advanced stage. Higher tumour burden. Requires prompt, aggressive treatment. | Beta-2 microglobulin ≥ 5.5 mg/L + low albumin |
It is important to understand that staging in Myeloma does not work the same way as in solid tumours like breast or lung cancer. A Stage 3 diagnosis does not mean the cancer has spread to other organs — it reflects the level of tumour burden in the bone marrow. All stages of Multiple Myeloma are treated with similar types of drugs; the intensity and urgency of treatment varies.
Multiple Myeloma Treatment – Options Available in India and Ahmedabad
The treatment of Multiple Myeloma has transformed dramatically over the last decade. What was once considered a largely incurable cancer is now managed as a chronic, controllable condition for many patients — with survival times of 7–10+ years increasingly common for patients who respond well to modern treatment protocols.
At Medisquare Superspeciality Hospital, Ahmedabad, Dr. Ekta Vala Chandarana designs individualised treatment plans for every Multiple Myeloma patient based on their age, fitness, disease stage, genetic risk profile, and personal preferences.
| Treatment | How it works | Used when |
| Chemotherapy | Kills fast-dividing myeloma cells using drugs like Melphalan, Cyclophosphamide | Often used before stem cell transplant or in combination regimens |
| Targeted therapy | Proteasome inhibitors (Bortezomib, Carfilzomib) block proteins myeloma cells need to survive | First-line and relapsed/refractory Myeloma |
| Immunomodulatory drugs | Thalidomide, Lenalidomide, Pomalidomide — boost immune response against myeloma cells | Combined with steroids and proteasome inhibitors |
| Monoclonal antibodies | Daratumumab, Elotuzumab — target specific proteins on myeloma cells | Relapsed or refractory cases; increasingly first-line |
| Stem cell transplant | High-dose chemo followed by transplant of patient’s own stem cells (autologous) | Eligible patients under ~70 with good organ function |
| Immunotherapy (CAR-T) | Engineered T-cells attack myeloma cells | Advanced/relapsed cases; rapidly expanding availability in India |
Standard first-line treatment in India (VRd regimen)
The most widely used first-line regimen for Multiple Myeloma in India is VRd — Bortezomib (Velcade) + Lenalidomide (Revlimid) + Dexamethasone. This triplet combination achieves deep responses in the majority of patients and is now the international standard of care. Daratumumab-based quadruplet regimens (Dara-VRd) are increasingly used for eligible patients and offer even deeper responses.
Stem cell transplant — who is eligible?
For patients who are under approximately 70 years of age and medically fit, autologous stem cell transplantation (ASCT) — where the patient’s own stem cells are harvested, stored, and returned after high-dose chemotherapy — remains an important part of the treatment pathway. It deepens and prolongs responses achieved with initial therapy.
Not all patients are eligible or wish to undergo transplant. Dr. Ekta Vala will discuss transplant eligibility with you in detail at your consultation in Ahmedabad — it is a highly individual decision.
Treatment for relapsed or refractory Multiple Myeloma
Multiple Myeloma typically relapses after initial treatment. This does not mean treatment has failed — relapse is expected and planned for. Multiple subsequent lines of therapy are available, including newer monoclonal antibodies (Daratumumab, Isatuximab), next-generation proteasome inhibitors, cereblon E3 ligase modulators (CELMoDs), and CAR-T cell therapy for advanced cases.
Living With Multiple Myeloma — What to Expect
A Multiple Myeloma diagnosis changes life significantly — but it does not have to end it. Many patients in India continue to work, travel, and spend quality time with family throughout treatment. Here is what to expect:
- Treatment is typically given in cycles — most outpatient, at a day-care oncology unit
- Regular monitoring with blood tests and scans every 2–3 months during active treatment
- Bone health management — bisphosphonates (Zoledronic acid) are given to protect bones and reduce fracture risk
- Infection prevention — Myeloma and its treatment weaken immunity; vaccinations and prophylactic antibiotics are often prescribed
- Fatigue management — one of the most common complaints; regular gentle exercise, nutrition support, and adequate sleep are all evidence-based strategies
- Emotional support — our oncology team in Ahmedabad includes guidance on support groups, counselling, and financial assistance for treatment costs
Every Multiple Myeloma patient is different. The journey for a 45-year-old with Stage 1 low-risk disease is very different from that of a 70-year-old with high-risk genetics. The single most important step you can take is to consult a specialist haematologist or oncologist who will build a treatment plan that is right for you specifically.
Frequently Asked Questions
Is Multiple Myeloma curable?
Currently, Multiple Myeloma is not considered curable in the traditional sense — but it is highly treatable. With modern treatment, many patients achieve complete or near-complete remission and live for many years. Research into CAR-T cell therapy and other immune-based treatments is advancing rapidly, and long-term cure may become achievable for some patients within the next decade.
What is the survival rate for Multiple Myeloma in India?
The 5-year relative survival rate for Multiple Myeloma has improved dramatically — from under 25% two decades ago to over 55–60% today with access to modern treatments. Patients diagnosed at Stage 1 with standard-risk genetics and good access to care can achieve median overall survival of 10+ years. Survival data from leading Indian cancer centres is approaching international benchmarks as newer drugs become more accessible.
What is the difference between Multiple Myeloma and leukaemia?
Both are blood cancers but they affect different cell types. Leukaemia originates in white blood cells (mainly in the bone marrow or lymphatic system) and often involves high white blood cell counts in the blood. Multiple Myeloma originates specifically in plasma cells and typically stays within the bone marrow, causing bone damage and abnormal protein production. They are diagnosed and treated differently.
Can Multiple Myeloma be treated in Ahmedabad?
Yes. Multiple Myeloma is fully treatable at Medisquare Superspeciality Hospital, Ahmedabad, under the care of Dr. Ekta Vala Chandarana. All standard first-line regimens including VRd, Daratumumab-based combinations, and autologous stem cell transplant coordination are available. You do not need to travel to Mumbai or Delhi for world-class Myeloma care — it is available here in Gujarat.
How do I know if I need to see an oncologist for back pain?
Ordinary back pain from posture or muscle strain is extremely common. However, see a doctor urgently if your back pain is: new and unexplained without any injury, worse at night or when lying down, associated with unexplained weight loss or fatigue, occurring alongside frequent infections, or if you are over 50 with no prior history of back problems. These patterns can indicate bone involvement from Myeloma or another serious condition.
Consult a Multiple Myeloma Specialist in Ahmedabad
If you or a family member has been diagnosed with Multiple Myeloma, or if your blood test has flagged abnormal proteins and you are awaiting further investigation, please do not delay seeking specialist input. Early, expert intervention changes outcomes significantly.
Dr. Ekta Vala Chandarana is one of Ahmedabad’s most experienced haematologists and medical oncologists, with specific expertise in Multiple Myeloma, Lymphoma, Leukaemia, and all blood cancers. She sees patients at Medisquare Superspeciality Hospital, Ahmedabad, and offers consultations in English, Hindi, and Gujarati.
Book an appointment: Call 08866843843 | Medisquare Superspeciality Hospital, O-201/202, Gala Empire, Drive In Road, Gurukul, Ahmedabad 380052
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Written & Medically Reviewed by
Dr. Ekta Vala Chandarana
Medical Oncologist & Hemato-Oncologist | Multiple Myeloma & Blood Cancer Specialist
Medisquare Superspeciality Hospital, Ahmedabad, Gujarat | 10+ years experience