5-24 JOHN Multiple Myeloma Flashcards
What are the 4 things you must know about Multiple Myeloma?
Monoclonal plasma cell prolif
Monocolonalgammopathy
↓normal Ig’s (malig cells secrete something –> ↓Ig from normal cells)
Osteolytic lesions
What is an M-spike?
Monoclonal gammopathy
Which Ig’s are elevated in MM?
Usually, IgG, could be others, NEVER IgM!
What do you find in MM patient urine? Why is this bad?
Bence-Jones protein (light chains)
Bad b/c kidney is supposed to filter proteins, => protein is being strained
through glomerulus KIDNEY DMG
What morphology do we see in blood and BM w/ MM?
Blood: anemia, rouleaux (haha, think roulette, poker chips, stacked RBCs)
Marrow: ↑plasma cells, amyloid
What are other Plasma Cell Tumors (aside from MM)?
Solitary plasmacytoma – collection of plasma cells in just 1 part of body
Plasma cell leukemia – Plasma cells IN THE BLOOD
Waldenstroem macroglobulinemia – IgM. Can –> hyperviscosity
MGUS (Monoclonal gammopathy of undetermined significance)
-small M-spike w/ no myeloma Sx
-can sometimes BECOME myeloma
What is the classic triad of Myeloma?
Anemia, bone pain, renal failure
Why do MM patients get anemia?
B/c PC’s in BM crowd out other cells
Why do MM patients get bone pain?
It’s associated w/ multiple lytic bony lesions.
What is the major COD in MM patients?
Infxn
Renal failure
Tx for MM?
Thalidomide, some others
When treating MM, what do we track?
M-spike
