6.8 - Plasma cell disorders (dyscrasias) Flashcards
which interleukin may be elevated in multiple myeloma?
IL-6
why is bone pain / punched out lesions with hypercalcemia seen in multiple myeloma?
neoplastic plasma cells activate RANK receptor on osteoclasts
why is elevated serum protein seen in multiple myeloma?
neoplastic plasma cells produce Ig (usually monoclonal IgG, IgA)
why is there an increased risk of infection in multiple myeloma?
monoclonal antibody lacks antigenic diversity
why is rouleaux formation seen in multiple myeloma?
increased serum protein decreases charge between RBCs
why is primary AL amyloidosis seen in multiple myeloma?
free light chains circulate in serum and deposit in tissues
why is proteinuria seen in multiple myeloma?
free light chain is excreted in the urine as bence jones protein - deposition in kidney TUBULES leads to risk for renal failure
what are bence jones proteins?
free light chain excreted in the urine in multiple myeloma
what is the manifestation of MGUS?
- increased serum protein with M spike on SPEP
- other features of multiple myeloma are absent
waldenstrom macroglobulinemia is what type of cancer?
B cell lymphoma with monoclonal IgM production
what are the clinical features of waldenstrom macroglobulinemia?
- generalized lymphadenopathy
- NO bone lesions
- increased serum protein with M spike (comprised of IgM)
- visual and neuro deficits (retinal hemorrhage, stroke) - IgM causes serum hyperviscosity
- bleeding - defective platelet aggregation
how is waldenstrom macroglobulinemia treated?
acute: plasmapheresis - removes IgM from serum
