Multiple myeloma kills primarily through complications caused by the disease’s effects on the body’s organs and immune system rather than directly by the cancer itself.

• The cancerous plasma cells in multiple myeloma accumulate in the bone marrow, crowding out healthy blood cells. This leads to anemia (causing fatigue), impaired immune function (leading to infections), and reduced platelet production (causing bleeding issues)

• The abnormal myeloma cells produce large amounts of defective antibodies (M proteins) that can accumulate and damage organs, especially the kidneys, often resulting in kidney failure

• Bone damage is common due to myeloma cells activating other marrow cells that break down bone, causing severe bone pain and increasing the risk of fractures

• Many patients die from infections because their immune system is weakened by the disease and its treatments

• Kidney failure is another leading cause of death, as the kidneys are damaged by the buildup of abnormal proteins and other disease effects

• Disease progression itself, with increasing tumor burden and organ dysfunction, is a primary cause of death in later stages

• In the final stages, symptoms such as extreme fatigue, bone pain, loss of appetite, breathing difficulties, and bleeding problems become pronounced

In summary, multiple myeloma kills mainly by causing kidney failure, severe infections due to immune suppression, and organ failure related to disease progression and bone damage. Death often results from these complications rather than the cancer cells directly