What is Anemia in Myeloma?

Anemia is a condition where there are not enough healthy red blood cells to move sufficient oxygen throughout your body. Also known as "low hemoglobin," anemia can make you feel severely weak and tired. 

There are several different types of anemia, all caused for different reasons. 

Why Does Myeloma Cause Anemia? 

Multiple myeloma is a blood cancer of the plasma cells. About 65% of myeloma patients have anemia at diagnosis. In anemia caused by multiple myeloma, an overgrowth of the myeloma plasma cells can crowd out normal red blood cells. When the body is not receiving enough oxygen, it can cause fatigue, weakness, dizziness, rapid heartbeat, leg swelling, headache and shortness of breath. Anemia may be the first sign of multiple myeloma. 

Anemia can also be caused by multiple myeloma therapy, including immunomodulators such as Revlimid and Pomalyst, the proteasome inhibitor Kyprolis and anti-CD38 monoclonal antibodies. 

Treating the multiple myeloma will typically reduce or eliminate the anemia because it clears out the excess myeloma plasma cells to return the bone marrow and blood to normal ratios of red vs. white blood cells. 

How is Anemia in Multiple Myeloma Treated? 

Anemia in multiple myeloma patients usually dissipates as the patient is effectively treated with myeloma treatments. As the myeloma cells die, healthy cells are able to take their place and normalize red blood cell levels. 

Blood transfusions could work temporarily but should not be used as a long-term solution. 

Some prescription medicines can be prescribed by your doctor if you are taking any medications that cause anemia (as listed above). Talk to your doctor about your options. 

What is Aplastic Anemia?

In aplastic anemia, your body stops producing new red blood cells. This causes fatigue and increases the likelihood of infections and uncontrolled bleeding. It can be mild or severe, happen at any age, and can occur slowly or happen suddenly. Treatment may include blood transfusions or a bone marrow transplant. 

What is Iron Deficiency Anemia? Does Myeloma Cause Iron Deficiency Anemia? 

Iron deficiency anemia is caused by inadequate iron levels. Without enough iron, your body can't produce enough hemoglobin or the substance in red blood cells that helps them carry oxygen through the body. Iron deficiency anemia can cause shortness of breath and fatigue. It can typically be corrected with iron supplements.

Multiple myeloma does not cause iron deficiency anemia, but the two can coexist, meaning that if you still have anemia after being treated by the myeloma, consider increasing the iron in your diet or consulting your medical team about an iron supplement. 

What is Sickle Cell Anemia?

Sickle cell anemia is a genetic disorder in the sickle cell disease family. It changes the shape of red blood cells to a crescent shape instead of a round-shaped cell. These sickle cells can become stiff and sticky which can block blood flow. There is no cure, but treatments can relieve pain and address disease complications.  

What is Thalassemia?

Thalassemia is a genetic condition that lowers your hemoglobin levels. Mild thalassemia may not require treatment, but more severe types may require blood transfusions. A healthy diet and regular exercise is helpful for people with this condition.

What is Vitamin Deficiency Anemia?

Vitamin deficiency anemia is caused by lowered amounts of B-12 and folate. This can happen if you don't eat enough foods with these vitamins or if your body struggles to absorb these vitamins. Without these vitamins, the body makes larger red blood cells that have a reduced ability to carry oxygen. Vitamin supplements can correct this condition.

If you have frequent fatigue or weakness, please talk to your doctor who can run blood tests to determine the underlying cause of the anemia. 

Curious about other symptoms of multiple myeloma? Read more here: CRAB Symptoms of Myeloma 

Wanting to improve your iron-deficient or vitamin-deficient anemia through diet? Learn more here: Combating Anemia, Fatigue, and GI Myeloma Side Effects Through Diet