Plasma cell disorders
Multiple myeloma
If you or someone you love has just heard this diagnosis, start here. This guide explains what the condition is, how it is usually treated and where a transplant fits.
Multiple myeloma is a cancer of antibody-producing plasma cells. Treatment combines medicines directed at the myeloma; eligible patients may receive high-dose chemotherapy followed by their own stem cells, while donor transplantation is uncommon.
Other names and abbreviations
PCM, MM, myeloma, Kahler disease, bone marrow cancer
In short
- Multiple myeloma is a cancer of plasma cells. These are the cells in the bone marrow that normally make antibodies.
- First treatment commonly combines several medicines. They are chosen to fit each person's fitness, kidney function and disease risk.
- The usual transplant returns a person's own stem cells after high-dose chemotherapy. Standard CAR-T therapy also starts from their own cells. Donor transplants are uncommon.
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Underlined words open a short explanation. See all terms
Where transplant fits
The usual myeloma transplantA treatment that gives a patient healthy blood-forming stem cells through a vein. The cells travel to the bone marrow and replace faulty marrow or marrow damaged by treatment. They can come from the patient or a donor. is autologousComing from the patient's own body. In an autologous transplant, the patient's own stem cells are collected and stored, then given back after high-dose treatment. It does not use a donor. and uses the patient’s own stem cellsYoung cells that can grow into every type of blood cell: red cells that carry oxygen, white cells that fight infection and platelets that help blood clot. They are found in the bone marrow and the bloodstream.. Standard autologous CAR-TA treatment that takes a patient's own T cells, changes them in a lab so they can find and attack cancer cells, then gives them back through a vein. Standard CAR-T therapy does not use a donor. uses their own modified T cellsA type of white blood cell that is part of the immune system. T cells grow from stem cells in the bone marrow, help protect the body from infection and may help fight cancer.. Allogeneic transplantationComing from another person. In an allogeneic, or donor, transplant, the stem cells come from a relative or an unrelated volunteer whose cells are a close enough match to the patient's. is uncommon, so most myeloma cellular treatment does not require a registry donor.
Treatment depends on the exact diagnosis, disease stage, prior treatment and the person’s health.
Key facts
- Who it affects
- Myeloma mainly affects older adults; risk varies by age, ancestry and family history.
- How common
- 7.4 new cases per 100,000 people a year; median age at diagnosis 69Age-adjusted rate, U.S. SEER 21 areas, people diagnosed 2019–2023 Source: How common
- Cells used in a transplant
- The patient’s own collected cells for autologous rescue; donated blood-forming cells only when an allogeneic procedure is selected.
- Where a donor fits
- Cell or gene therapy options
The condition
What it is
Plasma cells normally make antibodiesA protein made by the immune system that sticks to one specific target, such as a germ. Some wrongly target the body's own tissues. Lab-made antibody medicines can target markers such as CD20 or CD38 on some cancer cells.. In myeloma, one abnormal plasma-cell population expands in marrowThe soft, spongy tissue in the center of most bones. Red bone marrow holds the blood-forming stem cells that make red blood cells, white blood cells and platelets. and may produce a monoclonal protein or free light chains. These cells and proteins can damage organs as well as interfere with blood production.
Diagnosis uses blood and urine tests, marrow findings and imaging. MGUS and smoldering myeloma are related conditions that do not automatically require the same treatment as active myeloma. Clinical criteria and risk assessment determine the next step.
Marked as affected: plasma cells.
- Blood stem cell, In the bone marrow
- Myeloid line
- Red blood cells
- Platelets
- Granulocytes
- Monocytes
- Lymphoid line
- B cells
- Plasma cells, Affected, Develop from B cells
- T cells
- NK cells, Natural killer cells
- Myeloid line
What causes it
Acquired genetic changes in plasma cells affect their growth and interactions with the marrow environment. Myeloma usually develops through a precursor state, often previously undetected.
It is more common in older adults, and risk varies among populations and families, but most people have no identifiable preventable cause. It is not contagious. A mutation found in myeloma cells does not automatically mean an inherited disorder.
Symptoms and effects
Myeloma can weaken bone, causing pain or fractures, and may raise blood calcium. Anemia can cause fatigue and breathlessness. Abnormal light chains and other effects can impair kidney function.
Normal antibody production can be reduced, increasing infection risk. Some patients have few symptoms at diagnosis, so treatment decisions use laboratory and imaging evidence of organ damage or other myeloma-defining features, not symptoms alone.
Two drawings of bone marrow. Healthy marrow holds a mix of blood-forming cells and some fat. In marrow with myeloma, many plasma cells fill the space, leaving less room for the cells that make other blood cells.
Healthy marrow
Marrow with myeloma
- Blood stem cell
- Red cell
- Granulocyte
- Monocyte
- Lymphocyte
- Platelet
- Plasma cell
- Fat space
Real marrow holds millions of cells, and the share of each kind here is not to scale. How much of the marrow the myeloma cells fill differs from person to person.
Diagnosis and treatment
How multiple myeloma is diagnosed
Myeloma is sometimes found when blood or urine tests are done for another reason. Other times, bone pain, a broken bone, tiredness or frequent infections lead to tests. Blood and urine tests measure the abnormal protein made by myeloma cells (M protein) and free light chains. A test called immunofixation shows exactly which protein it is.
A bone marrow biopsy shows what share of the marrow is abnormal plasma cells. The marrow is also sent for gene tests on the myeloma cells (cytogenetics and FISH). These look for changes linked to higher-risk disease. Scans check the bones for damage. Depending on the center, this may be x-rays of the whole skeleton, or CT, PET-CT or MRI scans.
Doctors then decide whether this is active myeloma or an earlier stage. Active myeloma means abnormal plasma cells plus signs of harm, such as high calcium, kidney problems, anemia or bone damage, or certain very high-risk lab results. Blood levels of beta-2 microglobulin, albumin and LDH, together with the gene tests, set the stage (R-ISS).
MGUS and smoldering myeloma are earlier stages. People with MGUS have no symptoms and do not need treatment. They have regular check-ups instead, because a small share go on to develop myeloma or a related condition.
How it is treated
Initial therapy commonly combines several medicine classes, including a proteasome inhibitor, an immunomodulatory medicine, a steroid and often an anti-CD38 antibody. The regimen is adapted to medical fitness, kidney function, disease risk and access.
For eligible patients, high-dose melphalanVery strong drug treatment given in large doses, often to kill cancer cells. It also destroys the bone marrow and can cause other serious side effects. A stem cell transplant usually follows to rebuild the marrow. followed by autologous stem cell rescue can deepen and prolong disease control. The cells are collected beforehand from the patient. Timing and maintenance treatment are individualized; an autologous transplant is not a guaranteed cure.
RelapsedWhen a disease comes back after a period of getting better. Relapsed disease has returned after treatment helped for a time. disease may be treated with different combinations, CAR-T therapy, bispecific antibodies or clinical trialsA research study that tests how well a new medical approach works in people. Trials can test new ways to screen for, prevent, diagnose or treat a disease.. Allogeneic transplantation has a much narrower role because its risks must be weighed against these alternatives and it is not standard routine myeloma care.
Kinds of treatment described for multiple myeloma: supportive care, medicines, a donor stem cell transplant (for a few people), a transplant with the person’s own cells (for some people) and CAR T-cell therapy.
After diagnosis, the options described here
Supportive care
Care pays attention to bone health, kidney function, infection prevention, pain and mobility.
Medicines
First treatment commonly combines several medicines, chosen to fit each person’s fitness, kidney function and disease risk.
Donor stem cell transplant, For a few people
A transplant from a donor is used only in uncommon situations, because its risks must be weighed against other treatments.
What a transplant involvesTransplant with the person’s own cells, For some people
For eligible people, high-dose chemotherapy is followed by their own stem cells, collected beforehand.
What a transplant involvesCAR T-cell therapy
Myeloma that comes back may be treated with CAR-T therapy, which starts from the person’s own T cells.
These are the kinds of treatment this page describes, not a plan. Which ones fit, in what order and whether they are combined differs from person to person.
When transplant specialists are usually consulted
NMDP and ASTCT guidelines recommend that people with myeloma see a transplant team at diagnosis, and again if the myeloma progresses or comes back. For most people this visit is about planning a transplant with their own cells, not a donor search.
Read the guidanceWhat a transplant involves
- Step 1
: Collecting the person’s own cells
Medicines move stem cells out of the marrow and into the blood. The cells are then collected and frozen.
- Step 2
: High-dose treatment
The person receives strong treatment, usually high-dose chemotherapy.
- Step 3
: Cells returned, Day 0
The stored cells are thawed and given back through a vein, like a transfusion.
- Step 4
: Blood counts recover
The returned cells settle in the marrow and start making blood cells again.
- Step 5
: Follow-up
The care team keeps checking recovery and watches for infection and for the condition coming back.
Daily life and the donor’s role
Living with the condition and treatment
Care may involve long periods of treatment and monitoring, with attention to bone health, kidney function, infection prevention, pain and mobility. The burden is not measured only by the monoclonal protein level.
Autologous transplantation includes cell collection, high-dose chemotherapy and recovery from low blood counts. CAR-T therapy follows a different process and has its own immune and neurological risks. Rehabilitation and practical support may be needed with either approach.
The role of a blood stem cell donor
The usual myeloma transplant uses the patient’s own blood-forming cells. Approved autologous CAR-T therapies also begin with the patient’s cells, but they modify T cells to recognize the cancer. These are different treatments, and neither uses a registry donor.
A donor is relevant only in the uncommon situation where allogeneic transplantation is selected. Registry volunteers help patients with many diseases, but the typical person having a myeloma transplant does not need an unrelated donor match.
Highlighted here: the person’s own cells.
The person’s own cells
Autologous transplant, no donor
Collected from the person before treatment, then given back.
A relative
Donor transplant (allogeneic)
A brother or sister may be a full match. Parents and children can be half-matched donors.
An unrelated volunteer
Donor transplant (allogeneic)
Found through a donor registry.
Donated cord blood
Donor transplant (allogeneic)
Collected from a baby’s umbilical cord after birth and stored in a public bank.
Looking ahead
Looking ahead
Outlook for multiple myeloma
Myeloma is highly treatable but rarely cured, and many people now live with it for years. Outlook has improved steadily. U.S. death rates from myeloma fell by an average of 3.0% a year from 2015 to 2024. The National Cancer Institute says median survival now exceeds 10 years. When chemotherapy first came into use, it was about 2 to 2½ years.
Several things shape outlook. Stage is one. Another is whether the myeloma cells carry high-risk gene changes, such as del(17p), t(4;14) or t(14;16). Kidney problems make the outlook worse at any stage. A very deep response, with no myeloma found even by the most sensitive tests (MRDA very small number of cancer cells left in the body during or after treatment. Only very sensitive lab tests find them. Some can spot one cancer cell among a million normal cells. Testing is used mostly in blood cancers.-negative), is linked with longer survival.
About these numbers. Each one says which group of people it comes from, and the place and years where the source gives them. It describes what happened across that group, not what will happen to any one person. And a figure measured among people who had a transplant is not the same as the number of people who need one.
- 63.7%Alive 5 years after diagnosis (relative survival)
People of all ages diagnosed with myeloma in 2016–2022, U.S. SEER 21 areas (excluding Illinois)
Read the source: Alive 5 years after diagnosis (relative survival) - 82% (stage I) to 40% (stage III)Alive 5 years after diagnosis, by R-ISS stage
3,060 adults with newly diagnosed myeloma enrolled in 11 international clinical trials in 2005–2012, International Myeloma Working Group (published 2015)
Read the source: Alive 5 years after diagnosis, by R-ISS stage - Falling about 3.0% a yearChange in U.S. myeloma death rate
Age-adjusted U.S. death rates, all races and both sexes, 2015–2024
Read the source: Change in U.S. myeloma death rate
Survival figures describe large groups of people diagnosed years ago, often before some of today’s treatments. They cannot predict how any one person will do.
Real stories
- Roy ChelsenAn FDNY firefighter whose myeloma returned after treatment. His family searched for more than two years before a matching donor was found.Read the story
- Trooper S. Renee PadgettA Washington State Trooper who turned her own myeloma treatment into a drive to put 1,000 people on the registry.Read the story
Common questions
Is multiple myeloma curable?
Rarely, but it is very treatable. The US National Cancer Institute calls multiple myeloma “highly treatable but rarely curable.” For eligible people, a transplant using their own stem cells can keep the disease under control for longer, but it is not considered a cure. Group statistics cannot predict what will happen to one person.
Does multiple myeloma need a bone marrow donor?
Usually not. The usual myeloma transplant is autologous, meaning it uses the patient’s own stem cells, collected beforehand. Approved CAR-T therapies for myeloma also start with the patient’s own cells. A transplant from a donor is used only in uncommon situations, because its risks must be weighed against other treatments. So the typical person having a myeloma transplant does not need an unrelated registry match.
Is multiple myeloma inherited?
Not usually. Myeloma develops from gene changes in plasma cells, and it is not always clear what causes them. Having a parent, brother or sister with myeloma raises the risk, but most people with myeloma have no affected relatives. Age, sex and ancestry also affect risk, and most risk factors cannot be changed. Like other cancers, myeloma is not contagious.
What are the first symptoms of multiple myeloma?
Symptoms can include bone pain, especially in the back or ribs; bones that break easily; feeling very tired; trouble breathing; frequent infections; and kidney problems. Myeloma can also raise blood calcium. Some people have few or no symptoms at first, so doctors use lab and imaging results, not symptoms alone, to decide whether treatment is needed.
Is MGUS the same as multiple myeloma?
No, though they are related. MGUS and smoldering myeloma involve abnormal plasma cells but do not automatically need the same treatment as active myeloma. In most people with MGUS, the abnormal protein level stays the same and causes no symptoms or health problems. The American Cancer Society says about 1% of people with MGUS develop a cancer such as myeloma or lymphoma each year, so regular checks guide what happens next.
What is the life expectancy with multiple myeloma?
There is no single number, and outlook has improved a lot. The National Cancer Institute says median survival now exceeds 10 years with newer treatments. Stage, gene changes in the myeloma cells, kidney function and how well treatment works all shape the outlook. The outlook section on this page gives the figures, with the groups they describe. Group numbers cannot predict what will happen to one person.
For your next appointment
Multiple myeloma
From the Jada Bascom Foundation disease library, jadabascomfoundation.org. Printed .
Questions to bring to your care team
- What did the FISH tests on my marrow show, and is my myeloma considered standard risk or high risk?
- What is my R-ISS stage, and how does it shape the treatment plan?
- If a transplant with my own cells is planned, when would my stem cells be collected, and could a second transplant be an option later?
- Will you test for measurable residual disease (MRD), and would the result change my treatment or maintenance?
- What is the exact name of the diagnosis or subtype, and what does it mean for treatment?
- What is the goal of each treatment you are suggesting?
- Is CAR-T cell therapy an option, and how does it compare with a transplant?
- Where can our family find support during treatment?
A one-page list to take to the next appointment, with room for notes.
Supporting someone with a diagnosisSupport for patients and families
These independent organizations offer information and support. JBF is not affiliated with them.
- International Myeloma Foundation Offers an InfoLine, education and a network of over 160 myeloma support groups for people with myeloma and their care partners.Worldwide
- Myeloma UK UK myeloma charity with an Infoline, Ask the Nurse, a peer buddy service and support groups for people with myeloma and families.United Kingdom
- Myeloma Patients Europe European nonprofit for people with myeloma and AL amyloidosis, running a community taskforce and a clinical trial navigator.Europe
Sources and further reading
- Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ), Health Professional Version
NCI, Accessed 2026-09-05 - Multiple Myeloma
EBMT Handbook / NCBI Bookshelf, Accessed 2026-09-05 - Indications for haematopoietic cell transplantation and CAR-T: 2025 EBMT practice recommendations
EBMT / Bone Marrow Transplantation, Accessed 2026-09-05 - Stem Cell and Bone Marrow Transplants for Cancer
NCI, Accessed 2026-09-05 - Cancer Stat Facts: Myeloma
National Cancer Institute, SEER Program, Accessed 2026-09-24 - Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ), Patient Version
National Cancer Institute, 2023-11-17 - CAR T Cells: Engineering Patients’ Immune Cells to Treat Their Cancers
National Cancer Institute, Updated 2025-02-26; accessed 2026-09-24 - What Causes Multiple Myeloma?
American Cancer Society, Revised 2025-02-28; accessed 2026-09-24 - Multiple Myeloma Risk Factors
American Cancer Society, Revised 2025-02-28; accessed 2026-09-24 - Can Multiple Myeloma Be Prevented?
American Cancer Society, Revised 2025-02-28; accessed 2026-09-24 - Is Cancer Contagious?
American Cancer Society, Accessed 2026-09-24 - Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group
Journal of Clinical Oncology (Palumbo A, et al.; International Myeloma Working Group), 2015; accessed 2026-09-26 - Plasma cell disorders: HCT consultation guidelines and outcomes (NMDP/ASTCT Recommended Timing for Transplant Consultation)
NMDP, Accessed 2026-09-26
This information explains a condition and its treatments. It cannot diagnose an illness or recommend treatment for an individual. Your care team can explain how the evidence applies to you. Written and source-checked by the Jada Bascom Foundation. Each page lists the published sources it draws on.
Ways to help
Other patients need a donor.
A transplant for multiple myeloma usually uses the patient’s own cells, but thousands of other patients need a donor. For many of them, that donor is a stranger who joined a registry.
Join the registry
JBF points you to the official registry that serves your country. It explains who can join and what donation involves.
Support this work
Gifts to the Jada Bascom Foundation support donor-awareness education like this page, community outreach, drive planning and referrals to official registries.
Help a family find a donor
Our family guide explains practical ways to help someone who needs a donor. A registration drive can add many potential donors at once, for them and for others.
More in the library
Keep learning
Part of 2 diagnosis guides, each explaining how its subtypes fit together: Myeloma and related plasma cell disorders and Types of blood cancer.
