Multiple Myeloma: Causes, Symptoms, and Treatment Options

Multiple myeloma is a cancer that affects plasma cells, a type of white blood cell found in bone marrow. These cells help fight infection by producing antibodies. In multiple myeloma, plasma cells grow out of control and crowd out healthy cells. The result can be weakened bones, poor immune function, and other serious health issues.

Lenalidomide (Revlimid) has become one of the main drugs used to manage this condition. But treatment goes beyond medication alone. This guide will walk you through the causes, symptoms, diagnosis, and available treatment options — including how the price of lenalidomide varies globally and how to find affordable alternatives.

What Is Multiple Myeloma?

Multiple myeloma is a type of blood cancer that starts in plasma cells. These cells normally produce antibodies to help your body fight infections. In myeloma, abnormal plasma cells multiply inside the bone marrow, forming tumors and interfering with normal blood cell production.

As the disease progresses, it can lead to complications like anemia, kidney failure, and bone damage. Multiple myeloma differs from other blood cancers such as leukemia (which affects white blood cells) and lymphoma (which affects the lymphatic system).

It’s classified as a hematologic malignancy and is considered incurable, though many people live for years with proper treatment.

Causes and Risk Factors

The exact cause of multiple myeloma is not known. However, several risk factors increase the chance of developing the disease:

• Age: Most cases are diagnosed in people over 60.
• Gender: Men are more likely than women to develop myeloma.
• Race: African Americans have a higher incidence.
• Family History: A close relative with the disease raises your risk.
• MGUS: Monoclonal gammopathy of undetermined significance can sometimes develop into myeloma.
• Toxin Exposure: Long-term exposure to pesticides or benzene may play a role.
• Obesity and Radiation: Both have been linked to a higher likelihood of developing the condition.

Genetic mutations and chromosomal abnormalities in plasma cells are also associated with disease progression.

Common Symptoms of Multiple Myeloma

Symptoms can vary depending on how far the disease has progressed. Some people may have no symptoms at all in the early stages.

Common symptoms include:

• Bone pain – especially in the spine, ribs, and hips
• Fatigue – usually caused by anemia
• Frequent infections – due to weakened immunity
• Nausea and confusion – linked to high calcium levels
• Kidney problems – seen in advanced stages
• Unexplained weight loss or appetite changes
• Numbness or tingling – due to nerve compression from bone lesions

These symptoms often overlap with other conditions, making early diagnosis challenging.

How Multiple Myeloma Is Diagnosed

Diagnosis usually starts with blood and urine tests after symptoms are noticed.

Diagnostic methods include:

• Blood tests: Check for M-protein, calcium levels, kidney function, and red/white cell counts
• Urine tests: Detect Bence Jones proteins (free light chains)
• Bone marrow biopsy: Confirms the presence of abnormal plasma cells
• Imaging scans: X-rays, MRIs, and PET-CTs look for bone damage or lesions
• Staging systems: The Revised International Staging System (R-ISS) helps determine severity

Additional tests like cytogenetics may guide treatment plans based on risk stratification.

Treatment Options for Multiple Myeloma

Multiple myeloma treatment depends on the patient’s age, overall health, stage of the disease, and response to earlier therapies. Though not curable, it is manageable with proper care.

First-Line Treatments

Most patients start with induction therapy to control the disease quickly. Common drug classes include:

• Immunomodulatory drugs (IMiDs):
  Lenalidomide (Revlimid) is a core medication in many regimens due to its ability to boost immune response and reduce tumor load.
• Proteasome inhibitors:
  Bortezomib (Velcade) blocks enzymes that cancer cells need to grow.
• Steroids:
  Dexamethasone helps reduce inflammation and enhances the effects of other drugs.

Popular combination regimens:

• VRd (bortezomib + lenalidomide + dexamethasone)
• Rd (lenalidomide + dexamethasone)

Stem Cell Transplant

For eligible patients under age 70, a stem cell transplant (SCT) may be offered after induction therapy. It involves high-dose chemotherapy followed by reinfusion of the patient’s own stem cells to restore blood function.

Not all patients qualify for transplant due to age, health, or comorbidities.

Maintenance Therapy

Following transplant or first-line therapy, many patients are placed on maintenance treatment to keep the cancer in remission.

Lenalidomide is often used alone for this purpose, taken daily or several days per month for an extended period. Studies show this approach extends progression-free survival.

Relapsed or Refractory Myeloma

If the cancer returns or doesn’t respond to initial treatment, second-line options include:

• Monoclonal antibodies: e.g., daratumumab
• CAR-T cell therapy: a form of personalized immunotherapy
• Other drug combinations: involving pomalidomide, carfilzomib, or reusing lenalidomide-based regimens

Every relapse is treated based on prior responses and patient condition.

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Cost of Lenalidomide: Global vs. India

Lenalidomide is one of the most prescribed drugs for multiple myeloma. However, it’s also one of the most expensive, especially in Western countries.

Why Cost Matters

Myeloma patients often need long-term therapy. In some cases, treatment can continue for years. This makes drug pricing a significant concern — especially in low- and middle-income countries.

Per-Capsule Pricing in India

If you’re comparing options, the lenalidomide 5mg price in India is approximately $65 for 30 capsules.
The lenalidomide 10mg price is around $90 for a monthly supply.
For patients needing higher doses, the lenalidomide 15mg price comes to about $110 per 30-capsule box.
The lenalidomide 25mg price is roughly $140 per box in the Indian generic market.

Many patients also ask about specific dose ranges. The lenalidomide capsules 10mg price remains among the most affordable options globally, especially for maintenance therapy.

International Price Comparison

Using data from recent pharma retail listings:

• United States: ~$26,071/month for branded Revlimid
• United Kingdom: £15,000–£18,000/month
• Canada: CAD $2380/month
• India: ~$140/month for 30 capsules (25mg)

The price disparity highlights why many international patients seek affordable lenalidomide alternatives from licensed suppliers in India.

Is Generic Lenalidomide Safe and Effective?

Generic versions of lenalidomide are widely used in global oncology centers. These drugs must meet strict bioequivalence standards, proving that they work the same way in the body as the branded version.

In India, the Drug Controller General of India (DCGI) regulates generics. Major manufacturers often supply to hospitals across Asia, Africa, and Latin America.

Always consult your oncologist before switching from branded to generic, especially during active treatment.

Conclusion

Multiple myeloma is a serious but manageable cancer when diagnosed early and treated effectively. Treatment involves a mix of drug therapy, stem cell transplant, and long-term monitoring. Lenalidomide plays a central role in both first-line and maintenance therapy.

However, cost can be a barrier for many patients. With access to generic versions from regulated markets like India, more people can afford ongoing treatment — improving outcomes and quality of life.