Multiple Myeloma: What Are the Risk Factors, and Is It Hereditary?

Multiple myeloma is a type of blood cancer that affects plasma cells. Plasma cells are part of your immune system and normally live in the bone marrow. 

Because multiple myeloma affects your blood rather than a specific organ, it can lead to many problems throughout your body. For example, multiple myeloma can cause low blood counts, infections, weak bones, and kidney problems.

Although multiple myeloma can be a serious condition, it’s rare. Your lifetime risk of developing this condition is less than 1%.

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Keep reading as we further discuss whether multiple myeloma is hereditary and what else puts you at risk for this condition.

What causes multiple myeloma?

Plasma cells are a part of your immune system. They make special proteins called antibodies and release them into your bloodstream. These antibodies attach to viruses and bacteria, helping your immune system destroy invaders.

In multiple myeloma, plasma cells multiply at an uncontrollable rate inside your bone marrow. This leads to abnormally high levels of antibodies in your blood. The excess plasma cells and antibodies can lead to health problems like:

• Low blood cell counts: The excess plasma cells can crowd out other important cells made by your bone marrow. These include red blood cells, white blood cells, and platelets.

• Weak bones: Multiple myeloma cells release substances that can lead to the breakdown of bones.

• Kidney failure: The abnormal antibodies made by multiple myeloma cells can attack your kidneys. This can lead to kidney failure or chronic kidney disease.

• Infections: People with multiple myeloma often have weaker immune systems. This is because the abnormal number of antibodies crowds out the normal infection-fighting antibodies made by your immune system.

Multiple myeloma risk factors

There are some risk factors that can increase your chance of developing multiple myeloma. These risk factors don’t directly cause multiple myeloma. But for some, they can increase the chance of developing the condition.

Age

You’re more likely to develop multiple myeloma as you get older. Most people diagnosed with multiple myeloma are over the age of 65. It is unclear why older adults are more frequently affected. Studies also show that younger adults who develop multiple myeloma are more likely to respond to treatment. 

Genetics

Multiple myeloma does run in families. You’re more likely to develop multiple myeloma if a close relative — like your parent or sibling — had it too. This suggests that genetics play a role in how it develops. But genes aren’t the whole story. 

Medical conditions

Certain medical conditions can make it more likely for you to develop multiple myeloma. These include:

• Monoclonal gammopathy of undetermined significance (MGUS)

• Early myelodysplastic syndrome (MDS)

• Waldenström’s macroglobulinemia

• Pernicious anemia

Immune system damage

Viruses that damage your body’s immune system — like human T-lymphotropic virus type 1 (HTLV-1) and human immunodeficiency virus (HIV) — are sometimes associated with multiple myeloma.

Chemical and environmental exposures

There are also some chemicals and environmental exposures that might put you at risk for multiple myeloma. These are usually occupational hazards. Some examples are:

• Radiation

• Asbestos

• Pesticides

• Herbicides

• Chemicals used in rubber manufacturing

Is multiple myeloma hereditary?

Your genes do play a role in developing multiple myeloma. But just inheriting certain genes isn’t enough for you to develop multiple myeloma. That’s why multiple myeloma isn’t considered a hereditary condition.

Medical conditions are considered “hereditary” when they’re caused by a gene passed on by a previous generation. Cancers, on the other hand, develop when healthy cells develop damage to their DNA. This damage can be triggered by changes in your genes (genetic mutations). And these changes can pass from one generation to the next.

However, the genetic mutations linked to multiple myeloma aren’t passed on this way. Instead, these mutations develop later in life. 

But that doesn’t mean genetics don’t matter. Multiple myeloma does run in families. If you have a family member with multiple myeloma, you’re at increased risk for the condition. In fact, the chance of getting multiple myeloma is 2 to 3 times higher if you have a first-degree relative with the condition. This suggests that genes do play a role, but experts aren’t completely sure how it fits together yet. 

Many people who have family members with multiple myeloma never develop it themselves. And most people who develop multiple myeloma don’t have a family history of it. So, while multiple myeloma isn’t hereditary, certain genes may increase your risk. This is especially true when combined with other risk factors like medical conditions or environmental exposures. 

How is myeloma diagnosed?

Multiple myeloma is diagnosed using a combination of blood tests, imaging studies, and a bone marrow biopsy. Multiple myeloma usually first shows up as decreased blood cell counts, which is typically the first clue. 

To formally diagnose multiple myeloma, there are several different types of steps involved, including:

• Antibody test: This measures antibodies in your blood that are specific to multiple myeloma.

• Lactate dehydrogenase (LDH): This protein, released by damaged tissue in your body, might be higher than normal in people with multiple myeloma.

• Imaging studies: These tests look for evidence of multiple myeloma in your bones. 

• A bone marrow biopsy: This test is used to confirm the diagnosis. 

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Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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