Is Multiple Myeloma Hereditary?

Multiple myeloma is a type of blood cancer that forms in plasma cells, white blood cells that produce infection-fighting antibodies.

Multiple myeloma is not hereditary, meaning it is not passed down through families. Instead, multiple myeloma develops due to genetic mutations (changes) in the DNA of plasma cells.

What causes these genetic mutations is not fully understood, but a combination of environmental, lifestyle, and family history factors likely plays a role.

Research shows that multiple myeloma develops when genetic mutations occur in the DNA of plasma cells. These mutations cause healthy plasma cells to transform into abnormal cancerous cells that grow and multiply uncontrollably in bone marrow.

While genetic changes to the DNA are what may cause multiple myeloma, abnormal chromosomes may contribute to the cancer development as well.

Genetic Mutations 

DNA has instructions for nearly all cellular functions, including how and when cells grow and divide. Specific genes control cell growth and death. When the DNA of these gene cells mutate (change), multiple myeloma can form.

Proto-oncogenes: One genetic mutation that can lead to multiple myeloma is a change in proto-oncogenes, which control how cells grow and divide. When these genes mutate, they are then called oncogenes. If oncogenes are activated (turned on), they can cause cancer cells to grow and divide out of control.

Tumor suppressor genes: Another genetic mutation that can lead to multiple myeloma is a change to tumor suppressor genes. These genes slow cell growth or trigger cell death at appropriate times. When a mutation causes tumor suppressor genes to deactivate (turn off), cancer can spread to other organs.

These two mutations aren’t typically inherited directly (passed from parent to child) but develop over time within the DNA of plasma cells. Multiple myeloma usually develops due to acquired genetic mutations that can occur in response to various environmental factors, such as exposure to herbicides like glyphosate. 

Chromosome Abnormalities 

A chromosome is a thread-like structure within a cell that holds the DNA. Changes or errors in chromosomes—such as deletions (missing parts) or translocations (segments that have swapped places)—can disrupt the DNA and, in turn, normal cell function. 

Chromosomal abnormalities can contribute to the uncontrolled growth of abnormal plasma cells in multiple myeloma. About 50% of people with multiple myeloma have a chromosome translocation, where parts of different chromosomes switch places. If this happens near an oncogene, it can switch on the oncogene, causing uncontrollable growth of abnormal cells. 

Some people with multiple myeloma have chromosomal abnormalities that make the disease more aggressive and resistant to treatment.

Multiple myeloma is not hereditary, meaning genetic mutations associated with the disease do not run in families and are not passed down from parent to child. However, a family history is one of the few well-established risk factors for multiple myeloma.

People with a first-degree relative, such as a parent or sibling, with multiple myeloma have a 2-4 times higher risk of developing the disease compared to the general population. 

Researchers are still investigating why people with a family history of multiple myeloma have a higher risk of the disease, but shared environmental or lifestyle factors, such as chemical exposures or dietary habits, may contribute. 

A family history of certain autoimmune disorders, such as rheumatoid arthritis, is also associated with a higher likelihood of developing multiple myeloma. This suggests that inherited immune system dysfunction may also contribute to this cancer in some cases.

In addition to family history, several risk factors are associated with an increased risk of developing multiple myeloma. These include: 

• Age: Multiple myeloma is most common in people who are 65 and older. The risk increases with age due to age-related changes in immune function and the development of acquired (non-inherited) genetic mutations over time. 
• Gender: Men are more likely to develop multiple myeloma than women, though the reasons for this difference are not fully understood. 
• Race: Black people are two times more likely to develop multiple myeloma than white people. The reason isn’t known, but genetic and environmental factors may play a role. 
• Underlying plasma cell conditions: People with underlying plasma cell conditions, such as monoclonal gammopathy of undetermined significance (MGUS) or solitary plasmacytoma, are at a higher risk for multiple myeloma. 
• Environmental exposures: Exposure to toxic chemicals like herbicides (weed killers) or microplastics increases the risk of developing multiple myeloma. These exposures can lead to DNA changes in plasma cells, potentially promoting cancer development.
• Obesity: Extra body weight is associated with an increased risk of multiple myeloma. Obesity can trigger chronic systemic (body-wide) inflammation, which can create an environment for cancer cells to grow. Obesity is also associated with hormonal imbalances that may promote cancer cell growth and survival. 

Multiple myeloma does not always cause symptoms in its early stages. When symptoms do develop, they are often subtle or mistaken for other health issues. It’s important to see a healthcare provider if you experience any of the following multiple myeloma symptoms, especially if they continue or worsen over time: 

• Bone pain: Multiple myeloma can weaken bones, making them more prone to fractures (breaks) and pain, even from minor injuries. You may notice persistent bone pain, especially in the back, hips, or skull.
• Frequent infections: Multiple myeloma affects immune function, increasing the likelihood of developing infections like pneumonia. 
• Fatigue and weakness: Multiple myeloma causes abnormal plasma cells to crowd out healthy red blood cells, leading to anemia (low red blood cell count). Anemia causes symptoms like fatigue, weakness, and shortness of breath. 
• Kidney problems: Multiple myeloma can damage the kidneys and cause hypercalcemia (high calcium levels in the bloodstream), leading to symptoms such as increased thirst, frequent urination, loss of appetite, and abdominal pain. 
• Numbness or weakness in legs: Nerve compression due to weakened bones or fractures can lead to numbness, tingling, or weakness in the legs. 

Your healthcare provider may order testing, including blood and urine tests, to determine if multiple myeloma is causing your symptoms.

Multiple myeloma can develop due to gene changes that turn healthy plasma cells into abnormal, cancerous cells. The gene changes often occur due to environmental factors or dietary habits.

Although multiple myeloma is not inherited, people with a family history of the disease have a higher risk of developing multiple myeloma.