What are typical risks associated with multiple myeloma?

• A. Vision loss.
• B. Bone fractures and kidney injury.
• C. Skin rash only.
• D. Liver failure only.

Answer: (B)

In multiple myeloma, two major risks drive most clinical concerns: bone damage and kidney injury. Malignant plasma cells prompt increased osteoclast activity and suppress osteoblasts, leading to lytic bone lesions. These porous areas weaken bones, making fractures—often vertebral—a common and serious complication that causes pain and mobility issues.

At the same time, the abnormal light chains produced by the myeloma can be filtered by the kidneys and form obstructive casts, injuring the renal tubules. This light-chain–related nephropathy, along with potential hypercalcemia from bone resorption, is a frequent cause of kidney injury in these patients. Together, these two risks—fragile bones prone to fractures and impaired kidney function—are central concerns in multiple myeloma management.