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Multiple Myeloma Awareness Month

Multiple Myeloma Awareness Month

The CRAB-criteria are typical symptoms of multiple myeloma. This disease is also known as Kahler’s disease as it was first described by the Austrian physician Otto Kahler. During ‘Multiple Myeloma Awareness Month’ in March, we put the disease in the spotlight and show how Janssen is committed to making it a treatable and in the future even curable condition.

Multiple Myeloma

Multiple myeloma occurs when plasma cells, a specific type of white blood cells, start growing in an uncontrolled way due to a mistake in their development. These malignant plasma cells (also called myeloma cells) end up in the bone marrow, where all different types of blood cells are produced. The uncontrolled growth of malignant plasma cells disrupts the production process of healthy blood cells, resulting in a shortage. Because there are often several (multiple) outbreaks in the bone marrow, the disease is known as multiple myeloma.  Annually about 700 people in Belgium are diagnosed with multiple myeloma. 1

A difficult diagnose

Multiple myeloma is not easy to diagnose. The symptoms often start gradually, so that patients might wait a while before going to the doctor. 2 Moreover, the symptoms are rather general and often still mild: they are consequently not specific to multiple myeloma alone, but also occur in several other conditions. 2 As a result of these general symptoms, the disease is sometimes diagnosed later than would be optimal for treatment. Although the symptoms are general, the simultaneous occurrence of a number of symptoms - the so-called CRAB-criteria - may indicate multiple myeloma. 


The CRAB-criteria refer to four symptoms that multiple myeloma patients are often confronted with. A combination of these symptoms may indicate multiple myeloma, but not all symptoms need to be present. The following criteria are briefly explained in the animation below:

  • Calcium (elevated)

  • Renal failure

  • Anaemia

  • Bone lesions

The uncontrolled growth of the malignant plasma cells in the bone marrow can affect the bones. Chalk (Calcium) can be released as a result of this bone degradation. This can lead to excessive calcium levels in the blood (hypercalcemia). Patients may be confronted with a range of complaints: loss of appetite, fatigue, concentration problems, confusion, difficult bowel movements, increased thirst, more frequent urination, nausea, dehydration, … 1 3 Patients with multiple myeloma also run a higher risk of impairment of kidney function or Renal dysfunction. 1 The proliferating plasma cells produce a certain abnormal protein, which can disrupt the normal functioning of the kidneys. 1 In addition, hypercalcemia contributes to kidney dysregulation. Although symptoms are often absent, there are possible signs such as fluid retention (e.g. in the legs), reduced urine levels, fatigue, confusion, … The malignant plasma cells can also disrupt the production of blood cells. This can lead to a shortage of red blood cells, leading to Anaemia. 1 Common complaints are fatigue, weakness, shortness of breath during exertion, palpitations and headaches. 1 As mentioned before, the proliferation of malignant plasma cells in the bone marrow can also lead to Bone damage, which can result in bone fractures or vertebral compression fractures. Patients often experience bone pain as a result of the bone damage. 1

Victories over Cancer 


Multiple myeloma is less known to the general public, but it does have a major impact on patients and their surroundings. At Janssen, we are committed to making multiple myeloma a treatable and in the future even curable condition. At the same time, we work every day to ensure that the symptoms of this disease are recognized more easily. Fortunately, our years of commitment have not been without results. However, we will need to continue to work to make new victories - small or large - in this type of cancer possible in the future as well. We do this both through innovative research and by working together with the people and organizations that are close to the patients and their families.

Share your story

During the whole month of March, we will be highlighting multiple myeloma and the CRAB-criteria. Do you want to help and give extra visibility to this disease? Then share your own story via social media!

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