Why does hypercalcemia occur in multiple myeloma?
Channel: Decoded Medicine
Date: 27/12/2020

Multiple Myeloma is a cancer of the plasma cells. The plasma cells are activated forms of B lymphocytes. The plasma cells normally produce normal immunoglobulins. Immunoglobulins are antibodies. In multiple myeloma, the cancerous plasma cells produce abnormal immunoglobulins. 

Hypercalcemia is an increase in serum calcium levels. In multiple myeloma, the malignant plasma cells release cytokines that stimulate osteoclasts, the bone destroying cells and inhibit osteoblasts, the bone forming cells. This leads to bone resorption (bone tissue is broken down and minerals including calcium are released into the blood). This release of calcium into the blood leads to hypercalcemia. 

Notably, cytokine induced osteolysis in multiple myeloma involves PTHrP and RANK/RANKL interaction.



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