Multiple Myeloma and Fever: Understanding the Connection and Managing Infection Risks

Multiple myeloma is a type of blood cancer that originates in plasma cells, a critical component of the immune system responsible for producing antibodies. This malignancy disrupts normal hematopoiesis—the process of blood cell formation—in the bone marrow, leading to a range of systemic complications. One of the hallmark features of multiple myeloma is its dual impact on the immune system: it can cause a reduction in white blood cells and neutrophils, weakening the body's ability to fight off infections, while simultaneously triggering the overproduction of abnormal immunoglobulins (monoclonal proteins). This imbalance often suppresses the production of healthy antibodies, further compromising immune defense.

Can Multiple Myeloma Cause High Fever?

While multiple myeloma itself does not typically cause persistent fever, patients may experience high fevers when secondary complications arise—most commonly due to infections. Because the disease impairs immune function, individuals with myeloma are more vulnerable to bacterial, viral, or fungal infections. Serious conditions such as pneumonia, urinary tract infections (UTIs), and gastrointestinal infections are frequent triggers of high fever in this population.

Common Infection Sites and Associated Symptoms

Pulmonary infections, including pneumonia, are among the most dangerous for myeloma patients. Symptoms may include high fever (often above 101°F or 38.3°C), chills, cough, shortness of breath, and chest pain. Similarly, urinary tract infections can present with fever, painful urination, urgency, and lower abdominal discomfort. Gastrointestinal infections may lead to fever accompanied by diarrhea, nausea, or vomiting.

It's important to emphasize that while fever can be alarming, it is usually a sign that the body is responding to an infection rather than a direct symptom of the cancer progressing. Prompt medical evaluation is crucial. Patients should seek immediate care if they develop unexplained fever, especially during periods of low blood counts following chemotherapy or other immunosuppressive treatments.

Managing Fever and Preventing Infections

When a myeloma patient develops a high fever, timely intervention is essential. Physicians typically perform blood cultures, imaging studies, and urine analyses to identify the source of infection. Treatment generally involves intravenous or oral antibiotics, antivirals, or antifungals depending on the suspected pathogen. In severe cases, hospitalization may be required for close monitoring and aggressive therapy.

Practical Tips to Reduce Infection Risk

Maintaining good hygiene is one of the most effective preventive measures. Regular handwashing, avoiding crowded places during flu season, and staying up to date with recommended vaccines (excluding live vaccines unless approved by a doctor) can significantly reduce infection risks. Additionally, patients should practice safe food handling, avoid raw or undercooked foods, and stay hydrated.

Although fever is relatively uncommon in stable myeloma cases without infection, any sudden onset of high temperature should be taken seriously. With proper medical support and proactive self-care, most infections can be managed effectively, allowing patients to maintain better quality of life throughout their treatment journey.