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Multiple Myeloma vs. Leukemia: What’s the Difference?

Posted on June 30, 2021
Medically reviewed by
Todd Gersten, M.D.
Article written by
Julie Scott, ANP-BC, AOCNP

Multiple myeloma and leukemia are both types of blood cancer. Though they have some similarities, they are separate and different diseases. Learning about these cancers starts with learning about the cells they originate from.

Normal Cell Function and Cancer

The bone marrow is located in the center of bones and is where blood cells are made. Types of blood cells include:

  • Red blood cells, which transport oxygen around the body
  • Platelets, which clot together to prevent bleeding and heal damaged blood vessel walls
  • White blood cells, which are infection-fighting cells

The bone marrow produces multiple types of white blood, one of which is called plasma. Plasma is the liquid portion of the blood. It contains many other substances that are necessary for the immune system to function properly, such as antibodies.

The body typically produces these cells in a regulated process, making only what is needed for the body to function normally. However, cells can become abnormal, and when the body produces too many of one type of cell, it can become cancer.

Multiple Myeloma Cause

Multiple myeloma develops when plasma cells begin to grow abnormally. The abnormally growing plasma cells then make an abnormal antibody, often referred to as M protein. The “M” technically stands for “monoclonal,” but the antibody is also called myeloma protein or an M spike. As more abnormal plasma cells are made, they crowd the bone marrow and keep it from producing other healthy cells normally.

Leukemia Cause

Leukemia is caused by an overproduction of other abnormal white blood cells, which also don’t function as they should. They, too, crowd up the bone marrow so fewer normal cells can be made.

There are multiple types of leukemia, classified by how quickly they are growing and what type of white blood cells are affected. The most common types of leukemia include:

Signs and Symptoms of Multiple Myeloma and Leukemia

In multiple myeloma, the abnormal plasma cells may lead to abnormalities in blood tests and can cause signs and symptoms in other organs of the body. (Symptoms are what a person experiences, such as abdominal pain or nausea. Signs are what others can observe and measure, such as a rash or a fever.)

These signs and symptoms may include:

  • Low red blood cell counts (anemia)
  • Low platelet counts (thrombocytopenia)
  • Low white blood cell counts (leukopenia)
  • High levels of blood calcium
  • Bone pain, weakness, or fractures
  • Shortness of breath
  • Kidney dysfunction
  • Tiredness
  • Weakness
  • Appetite changes and weight loss
  • Infections
  • Swelling
  • Confusion

Leukemia and multiple myeloma share some of the same signs and symptoms, as they are both blood cancers that prevent blood cells from being made normally. However, there are some differences. Other signs and symptoms of leukemia may include:

  • Fevers
  • Drenching night sweats
  • Easy bruising or bleeding
  • Swollen lymph nodes
  • Enlarged spleen

Diagnosis of Myeloma and Leukemia

The processes for diagnosing multiple myeloma and leukemia are similar. The first step is often a physical exam, as well as an evaluation of personal history and relevant risk factors. Your health care provider may want to evaluate the appearance of your skin and look for enlarged lymph nodes. They may also want to assess other body systems to check for signs and abnormalities. Then, they may perform blood tests, biopsies, and imaging tests.

Blood Tests

A health care provider will often order blood tests to further evaluate signs and symptoms if they are concerned about the possibility of leukemia or multiple myeloma. These blood tests may include the following.

Complete Blood Count

The complete blood count (CBC) gives the counts and sizes of each of the types of blood cells. For both leukemia and multiple myeloma, a CBC can show abnormal levels of these blood cells, especially low red blood cell and platelet counts. For cases of leukemia, a CBC may reveal high white blood cell counts.

Blood Chemistry

Blood chemistry tests evaluate the function of the liver and kidneys. They can also measure levels of electrolytes such as sodium, potassium, and calcium. In multiple myeloma, abnormal proteins can decrease kidney function. Some leukemias may affect kidney function as well. Elevated calcium levels may also be present in case of multiple myeloma.

Other Blood Tests

A doctor may order other tests if they suspect a person has multiple myeloma. These tests include:

  • Protein electrophoresis — This measures M protein in the blood. A similar test, called a urine protein electrophoresis, may also be conducted.
  • Serum-free light chains tests — These look at the ratio of light chains (a type of protein in antibodies) in the blood.
  • Quantitative immunoglobulin tests — This test compares levels of certain antibodies in the blood.
  • Beta-2 microglobulin tumor marker test — This looks for high levels of beta-2 microglobulin, a protein made by the myeloma cells.

Other tests for leukemia may include flow cytometry, a specialized test that looks for certain markers on the white blood cells.

Bone Marrow Biopsy

A bone marrow biopsy examines a sample of the bone and marrow, usually removed from the hip bone. The marrow is then specially tested for the presence of myeloma or leukemia cells. Chromosomes may also be evaluated to help diagnose and determine the prognosis (outcome) of the cancers.

Imaging Tests

Imaging tests can help evaluate how your cancer has extended and where it is located. Types of imaging tests include:

  • CT
  • MRI
  • Ultrasound
  • Positron emission tomography

Treatment for Myeloma and Leukemia

Your health care team will consider many factors in determining the best treatment plan. These include the stage of your cancer and any of its particular markers or characteristics.

Some treatments for the two blood cancers may be similar.

  • ChemotherapyMedications are given to kill cancer cells, typically through intravenous infusion.
  • Immunotherapy — This employs medications that can help the immune system see the cancer cells and fight them. These are given through an intravenous infusion.
  • Stem cell transplant — For this procedure, your unhealthy cancer-producing bone marrow (or stem cells) are destroyed using high-dose chemotherapy. You are then infused with new healthy stem cells — either your own or from a donor.
  • Radiation therapy — This approach uses high-energy X-ray beams to target cancer cells and stop them from growing.
  • Targeted therapy — This uses special medications to recognize and target mutations or markers present in cancer cells.

It is very unlikely that someone would have multiple myeloma and leukemia at the same time. However, the treatments associated with these blood cancers can potentially increase the risk of developing another blood cancer in the future. Such occurrences are very rare.

Talk With Others Who Understand

MyMyelomaTeam is the social network for people with multiple myeloma and their loved ones. On MyMyelomaTeam, more than 11,500 members come together to ask questions, give advice, and share their stories with others who understand life with multiple myeloma.

Are you living with multiple myeloma or leukemia? Share your experience in the comments below, or start a conversation by posting on MyMyelomaTeam.

All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Julie Scott, ANP-BC, AOCNP is an adult nurse practitioner with advanced practice oncology certification, based in St. Louis, Missouri. Learn more about her here.

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