CHAPTER 27-IMMUNOPROLIFERATIVE DISEASES Flashcards
1
Q
What abnormal protein builds up and deposits in tissues and organs in Amyloidosis?
A
Amyloid
2
Q
What monoclonal globulin light chains are found in the urine; characteristic of multiple myeloma?
A
Bence Jones (BJ) protein
3
Q
What term refers to elevated calcium levels in the blood?
A
Hypercalcemia
4
Q
What are conditions characterized by abnormally high levels of gamma globulins in the blood called?
A
Hypergammaglobulinemias
5
Q
What term refers to increased thickness or resistance to flow of the blood?
A
Hyperviscosity
6
Q
What term describes a slow-growing or minimally progressive condition?
A
Indolent
7
Q
What plasma cell disorder is characterized by the overproduction of either kappa or lambda light chains?
A
Light-chain disease (LCD)
8
Q
What monoclonal immunoglobulin protein is found in serum or urine; often associated with plasma cell dyscrasias?
A
M protein
9
Q
What condition is characterized by the overproduction of a single type of immunoglobulin by a clone of plasma cells?
A
Monoclonal gammopathy
10
Q
What plasma cell neoplasm is characterized by accumulation of malignant plasma cells in the bone marrow and monoclonal protein in blood or urine?
A
Multiple myeloma
11
Q
What cells are responsible for bone resorption and remodeling?
A
Osteoclasts
12
Q
What abnormal monoclonal immunoglobulin protein is produced in plasma cell disorders?
A
Paraprotein
13
Q
What are disorders characterized by abnormal proliferation or function of plasma cells called?
A
Plasma cell dyscrasias
14
Q
What condition is characterized by the elevation of multiple immunoglobulins produced by several clones of plasma cells?
A
Polyclonal gammopathy
15
Q
What term describes an arrangement of red blood cells resembling stacks of coins; often seen in multiple myeloma?
A
Rouleaux
16
Q
What asymptomatic premalignant stage of multiple myeloma exists?
A
Smoldering multiple myeloma
17
Q
What plasma cell disorder is characterized by the overproduction of IgM?
A
Waldenström’s primary macroglobulinemia (WM)
18
Q
What is the term to describe that plasma cells have single clone; one immunoglobulin type?
A
Monoclonal gammopathies
19
Q
What is the term to describe that plasma cells have multiple clones; several immunoglobulin types?
A
Polyclonal gammopathies
20
Q
Which protein screening procedure can detect monoclonal light chains in urine; indicative of plasma cell disorders?
A
Bence Jones Protein Screening Procedure
21
Q
What percentage of mononuclear cells are plasma cells in normal bone marrow?
A
<1%
22
Q
What immunoglobulins are predominantly produced by long-lived plasma cells in the bone marrow?
A
IgG and IgA
23
Q
What is the phenotype of well-differentiated plasma cells (CD markers)?
A
CD38bright; syndecan-1bright; CD19+; and CD56weak/−
24
Q
What is the term for the precursors to long-lived plasma cells?
A
Slowly proliferating plasmablasts
25
Where do plasmablasts migrate from to reach the marrow?
Lymph nodes
26
What stimulates plasmablasts to migrate to the marrow?
Antigens and cytokines from helper T (Th) cells
27
What events occur in the germinal centers to initiate plasma cell development?
Somatic mutations of immunoglobulin genes and class switching
28
Which immunoglobulin is typically switched to IgG or IgA?
IgM
29
What influences activated B cells to differentiate into plasma cells in the bone marrow?
Adhesion molecules and factors such as interleukin-6
30
How do normal plasma cells typically die?
Apoptosis
31
What is the origin of a monoclonal gammopathy?
Single clone of lymphoid plasma cells
32
What is produced in elevated levels in monoclonal gammopathy?
A single class and type of immunoglobulin
33
What are other terms for the monoclonal immunoglobulin in monoclonal gammopathy?
M protein or paraprotein
34
List disorders in the category of plasma cell dyscrasias.
Multiple myeloma (MM); Waldenström’s macroglobulinemia (WM); monoclonal gammopathy of undetermined significance (MGUS); light-chain deposition disease; and heavy-chain diseases
35
How is a polyclonal gammopathy classified?
Secondary disease
36
What characterizes a polyclonal gammopathy?
Elevation of two or more immunoglobulins by several clones of plasma cells
37
What characterizes Monoclonal gammopathies?
production of monoclonal immunoglobulin; suppressed uninvolved immunoglobulins; dysfunctional T cell responses
38
Which plasma cell disorder is the most common premalignant precursor of myeloma?
MGUS
39
Which assays demonstrate abnormal results in MM and WM?
Serum and urine electrophoresis and other immunoglobulin assays
40
Where can a dense; highly restricted band be found in the electrophoretic pattern of patients with MM and WM?
Gamma region
41
Which disease often does not exhibit a monoclonal band or spike in serum protein patterns?
light-chain disease (LCD)
42
What is synthesized by the clone in light-chain disease?
kappa (κ) or lambda (λ) monoclonal light chains
43
How are light chains filtered out of the body in light-chain disease?
Through the glomerulus and into the urine
44
How does the serum electrophoretic pattern appear in light-chain disease?
Hypogammaglobulinemia; faint or no monoclonal band
45
What does a nonsecretory clone suggest?
Hypogammaglobulinemia due to inhibition of normal clones
46
How is a polyclonal gammopathy defined?
Increase in more than one immunoglobulin; involves several clones of plasma cells
47
What does a polyclonal protein consist of?
One or more heavy-chain classes and both light-chain types
48
What are polyclonal increases exhibited as?
Secondary manifestations of infection or inflammation
49
In what conditions are polyclonal increases often seen?
Chronic infections; chronic liver disease; rheumatoid connective tissue (autoimmune) diseases; and lymphoproliferative disorders
50
What characterizes a polyclonal protein on electrophoresis?
Broad peak or band; usually of gamma mobility
51
How does a polyclonal protein appear on immunoelectrophoresis?
Thickening and elongation of all heavy-chain and light-chain arcs
52
How does a polyclonal protein appear on immunofixation?
Absence of a localized band
53
What does a selective polyclonal increase signify?
Elevation of only one class of immunoglobulin
54
How does Immunoglobulin produced in a selective polyclonal increase appear?
produced by several clones of plasma cells and both kappa and lambda types are produced
55
What procedure demonstrates which immunoglobulin is increased in a selective polyclonal increase?
Immunoglobulin quantitation by specific assay procedures
56
Is Immunofixation recommended in cases of polyclonal gammopathy?
No
57
What characterizes Multiple myeloma?
accumulation of malignant plasma cells within the bone marrow microenvironment; monoclonal protein in the blood or urine; and associated organ dysfunction
58
What percentage of the bone marrow is comprised of plasma cells in normal bone marrow?
about 1%
59
What percentage of the bone marrow is comprised of plasma cells in MM?
the plasma cell concentration can rise to 90%
60
How can monoclonal plasma cells be identified in the bone marrow?
histology based on identifying intracellular κ and λ chains using direct immunofluorescent techniques
61
How many heavy-chain types and light chain types can plasma cells produce?
one of five heavy-chain types together with κ and λ molecules
62
What is the free light-chain production %
compared to heavy chain?
63
What is the term for the malignant plasma cells that accumulate in the bone marrow microenvironment in MM?
Multiple myeloma cells
64
What term describes the monoclonal protein found in blood or urine in MM?
M protein or paraprotein
65
What organ dysfunction is associated with MM?
bone destruction; renal failure; anemia; hypercalcemia
66
What is the term for the bone pain caused by osteolytic lesions in MM?
Bone pain due to osteoclast activation
67
What is the term for the anemia commonly seen in MM?
Normocytic normochromic anemia
68
What is the term for the renal failure caused by light-chain deposition in MM?
Myeloma kidney or cast nephropathy
69
What is the term for the elevated calcium levels in MM?
Hypercalcemia
70
What is the term for the immunodeficiency state in MM due to suppressed normal immunoglobulins?
Hypogammaglobulinemia
71
What is the term for the diagnostic procedure that detects monoclonal proteins in serum?
Serum protein electrophoresis (SPEP)
72
What is the term for the diagnostic procedure that detects monoclonal light chains in urine?
Urine protein electrophoresis (UPEP)
73
What is the term for the assay that identifies specific immunoglobulin types in monoclonal gammopathies?
Immunofixation electrophoresis (IFE)
74
What is the term for the assay that quantifies free light chains in serum?
Serum free light-chain assay (FLC)
75
What is the term for the imaging technique used to detect bone lesions in MM?
Skeletal survey or whole-body low-dose CT
76
What is the term for the treatment that uses drugs to kill myeloma cells?
Chemotherapy
77
What is the term for the drug class that inhibits proteasome function in MM?
Proteasome inhibitors (e.g.
78
What is the term for the drug class that modulates the immune system in MM?
Immunomodulatory drugs (e.g.
79
What is the term for the treatment that replaces diseased bone marrow with healthy stem cells?
Stem cell transplantation
80
What is the term for the condition characterized by monoclonal IgM overproduction and hyperviscosity?
Waldenström’s macroglobulinemia (WM)
81
What is the term for the symptoms caused by hyperviscosity in WM?
Hyperviscosity syndrome (e.g.
82
What is the term for the treatment that removes excess IgM from plasma?
Plasmapheresis
83
What is the term for the asymptomatic premalignant stage of plasma cell disorders?
Monoclonal gammopathy of undetermined significance (MGUS)
84
What is the term for the risk of progression from MGUS to MM?
1% per year
85
What is the term for the condition where monoclonal light chains deposit in organs?
Light-chain deposition disease (LCDD)
86
What is the term for the condition where heavy-chain fragments are overproduced?
Heavy-chain disease (e.g.
87
What is the term for the test that differentiates monoclonal from polyclonal gammopathies?
Immunofixation electrophoresis (IFE)
88
What is the term for the broad peak seen in polyclonal gammopathies on electrophoresis?
Polyclonal band
89
What is the term for the chronic infections that often cause polyclonal gammopathy?
Bacterial; viral; or parasitic infections
90
What is the term for the autoimmune diseases associated with polyclonal gammopathy?
Rheumatoid arthritis; systemic lupus erythematosus (SLE)
91
What is the term for the liver disease that causes polyclonal gammopathy?
Chronic hepatitis or cirrhosis
92
What is the term for the lymphoproliferative disorders linked to polyclonal gammopathy?
Chronic lymphocytic leukemia (CLL); lymphoma
93
What is the term for the test that quantifies specific immunoglobulins in polyclonal gammopathy?
Immunoglobulin quantitation (e.g.
94
What is the term for the absence of a localized band on immunofixation in polyclonal gammopathy?
Polyclonal pattern
95
What is the term for the elevation of only one immunoglobulin class in polyclonal gammopathy?
Selective polyclonal increase
96
What is the term for the plasma cell disorder characterized by IgM M protein and lymphoplasmacytic cells?
Waldenström’s macroglobulinemia (WM)
97
What is the term for the genetic mutation commonly found in WM?
MYD88 L265P mutation
98
What is the term for the treatment targeting the MYD88 pathway in WM?
BTK inhibitors (e.g.
99
What is the term for the condition where plasma cells produce nonfunctional immunoglobulins?
Nonsecretory myeloma
100
What is the term for the hypogammaglobulinemia caused by nonsecretory clones?
Secondary hypogammaglobulinemia
101
What is the term for the diagnostic challenge in nonsecretory myeloma?
Absence of M protein in serum/urine
102
What is the term for the imaging used to detect extramedullary plasmacytomas?
PET-CT or MRI
103
What is the term for the plasma cell disorder with osteosclerotic bone lesions?
POEMS syndrome
104
What is the term for the triad of neuropathy; organomegaly; and endocrine dysfunction in POEMS syndrome?
POEMS criteria
105
What is the term for the cytokine elevated in POEMS syndrome?
Vascular endothelial growth factor (VEGF)
106
What is the term for the treatment targeting VEGF in POEMS syndrome?
Anti-VEGF therapy (e.g.
107
What is the term for the plasma cell disorder associated with AL amyloidosis?
Primary amyloidosis
108
What is the term for the amyloid protein in AL amyloidosis?
Amyloid light chain (AL)
109
What is the term for the organ damage caused by AL amyloid deposition?
Cardiac; renal; or hepatic amyloidosis
110
What is the term for the treatment that eliminates amyloidogenic plasma cells?
Chemotherapy or stem cell transplantation
111
What is the term for the assay that detects amyloid deposits in tissues?
Congo red staining with apple-green birefringence
112
What is the term for the plasma cell disorder with both MM and AL amyloidosis?
Overlap syndrome
113
What is the term for the prognostic marker in MM related to cytogenetic abnormalities?
High-risk cytogenetics (e.g.
114
What is the term for the staging system used in MM?
International Staging System (ISS)
115
What is the term for the revised staging system incorporating cytogenetics?
Revised ISS (R-ISS)
116
What is the term for the biomarker used to monitor MM treatment response?
Serum free light-chain ratio
117
What is the term for the condition where MM relapses after treatment?
Relapsed/refractory MM
118
What is the term for the novel therapy targeting BCMA in MM?
Anti-BCMA CAR-T cell therapy
119
What is the term for the bispecific antibody targeting BCMA and CD3 in MM?
Teclistamab
120
What is the term for the oral proteasome inhibitor used in MM?
Ixazomib
121
What is the term for the condition where MM cells become resistant to treatment?
Refractory myeloma
122
What is the term for the supportive care to prevent skeletal events in MM?
Bisphosphonates (e.g.
123
What is the term for the anemia treatment in MM using erythropoiesis-stimulating agents?
ESA therapy
124
What is the term for the infection prophylaxis in MM due to immunoparesis?
Antibacterial; antiviral; and antifungal prophylaxis
125
What is the term for the plasma cell disorder characterized by monoclonal IgA or IgG without organ damage?
Monoclonal gammopathy of undetermined significance (MGUS)
126
What is the term for the risk stratification tool used to predict MGUS progression?
Mayo Clinic Risk Stratification Model
127
What is the term for the condition where MGUS progresses to MM or related disorders?
Smoldering multiple myeloma (SMM)
128
What is the term for the phase between MGUS and active MM?
Smoldering multiple myeloma (SMM)
129
What is the term for the criteria used to diagnose active MM?
CRAB criteria (hyperCalcemia; Renal failure; Anemia; Bone lesions)
130
What is the term for the revised criteria adding biomarkers to diagnose MM?
SLiM criteria (≥60% plasma cells; serum free light-chain ratio ≥100; MRI bone lesions)
131
What is the term for the bone lesions caused by osteoclast activation in MM?
Osteolytic lesions
132
What is the term for the cytokine driving osteoclast activity in MM?
RANK ligand (RANKL)
133
What is the term for the drug inhibiting RANKL in MM?
Denosumab
134
What is the term for the renal toxicity caused by light chains in MM?
Cast nephropathy
135
What is the term for the treatment to prevent cast nephropathy?
Hydration; alkalinization; and avoiding nephrotoxic drugs
136
What is the term for the assay measuring free light chains in serum?
Serum free light-chain (FLC) assay
137
What is the term for the ratio used to detect clonal light-chain production?
Kappa/lambda free light-chain ratio
138
What is the term for the condition where both kappa and lambda light chains are elevated?
Polyclonal hypergammaglobulinemia
139
What is the term for the plasma cell disorder with IgM M protein and lymphoplasmacytic infiltration?
Waldenström’s macroglobulinemia (WM)
140
What is the term for the genetic test used to confirm WM?
MYD88 L265P mutation detection
141
What is the term for the therapy targeting Bruton’s tyrosine kinase in WM?
BTK inhibitors (e.g.
142
What is the term for the symptom of blurred vision in WM due to hyperviscosity?
Fundus hyperviscosity changes
143
What is the term for the emergency treatment to reduce IgM levels in WM?
Plasmapheresis
144
What is the term for the condition where plasma cells produce non-secretory immunoglobulins?
Nonsecretory myeloma
145
What is the term for the diagnostic challenge in nonsecretory myeloma?
Absence of M protein in serum/urine
146
What is the term for the imaging used to detect nonsecretory myeloma lesions?
Whole-body MRI or PET-CT
147
What is the term for the plasma cell disorder with osteosclerotic bone lesions and neuropathy?
POEMS syndrome
148
What is the term for the acronym POEMS?
Polyneuropathy; Organomegaly; Endocrinopathy; Monoclonal protein; Skin changes
149
What is the term for the elevated cytokine in POEMS syndrome?
Vascular endothelial growth factor (VEGF)
150
What is the term for the treatment targeting VEGF in POEMS syndrome?
Bevacizumab (anti-VEGF monoclonal antibody)
151
What is the term for the amyloidosis caused by light-chain deposits?
AL amyloidosis
152
What is the term for the Congo red staining pattern in amyloidosis?
Apple-green birefringence under polarized light
153
What is the term for the cardiac complication of AL amyloidosis?
Restrictive cardiomyopathy
154
What is the term for the treatment for AL amyloidosis targeting plasma cells?
Daratumumab (anti-CD38 monoclonal antibody)
155
What is the term for the plasma cell disorder with both MM and AL amyloidosis?
Overlap syndrome
156
What is the term for the cytogenetic abnormality del(17p) in MM?
High-risk cytogenetics
157
What is the term for the staging system incorporating albumin and β2-microglobulin in MM?
International Staging System (ISS)
158
What is the term for the revised staging system including cytogenetics in MM?
Revised ISS (R-ISS)
159
What is the term for the biomarker used to monitor minimal residual disease (MRD) in MM?
Next-generation sequencing (NGS) of clonal plasma cells
160
What is the term for the therapy using engineered T cells to target BCMA in MM?
Anti-BCMA CAR-T cell therapy (e.g.
161
What is the term for the bispecific antibody targeting BCMA and CD3 in MM?
Teclistamab
162
What is the term for the oral proteasome inhibitor used in relapsed MM?
Ixazomib
163
What is the term for the condition where MM becomes resistant to multiple therapies?
Triple-class refractory myeloma
164
What is the term for the supportive therapy to prevent bone fractures in MM?
Bisphosphonates (e.g.
165
What is the term for the anemia treatment using erythropoiesis-stimulating agents in MM?
ESA therapy (e.g.
166
What is the term for the infection prevention strategy in immunocompromised MM patients?
Antibacterial/antiviral/antifungal prophylaxis
167
What is the term for the plasma cell disorder causing soft tissue plasmacytomas?
Extramedullary plasmacytoma
168
What is the term for the solitary bone lesion without systemic involvement in MM?
Solitary plasmacytoma of bone
169
What is the term for the relapse of MM after stem cell transplantation?
Post-transplant relapse
170
What is the term for the maintenance therapy after autologous stem cell transplant in MM?
Lenalidomide maintenance
171
What is the term for the condition where MM cells invade peripheral blood?
Plasma cell leukemia
172
What is the term for the diagnostic threshold for plasma cell leukemia?
≥20% plasma cells in peripheral blood
173
What is the term for the aggressive form of MM with rapid progression?
High-risk MM
174
What is the term for the genetic abnormality t(4;14) in MM?
High-risk translocation
175
What is the term for the fusion gene caused by t(4;14) in MM?
FGFR3/MMSET
176
What is the term for the drug targeting FGFR3 in MM?
FGFR inhibitors (e.g.
177
What is the term for the condition where MM cells secrete only light chains?
Light-chain MM
178
What is the term for the nephropathy caused by light-chain deposition in renal tubules?
Myeloma cast nephropathy
179
What is the term for the proteinuria pattern in light-chain MM?
Bence Jones proteinuria
180
What is the term for the neurological symptom caused by hyperviscosity in WM?
Headache or stroke-like symptoms
181
What is the term for the bleeding tendency in WM due to IgM coating platelets?
Acquired von Willebrand syndrome
182
What is the term for the test diagnosing acquired von Willebrand syndrome in WM?
Von Willebrand factor activity (VWF:RCo)
183
What is the term for the treatment for acquired von Willebrand syndrome in WM?
IVIG or plasmapheresis
184
What is the term for the IgM-related neuropathy in WM?
IgM neuropathy
185
What is the term for the autoantibody causing neuropathy in WM?
Anti-myelin-associated glycoprotein (anti-MAG)
186
What is the term for the cold agglutinin disease sometimes seen in WM?
Cold agglutinin-mediated hemolytic anemia
187
What is the term for the therapy targeting cold agglutinins in WM?
Rituximab (anti-CD20 monoclonal antibody)
188
What is the term for the cytokine driving plasma cell survival in MM?
Interleukin-6 (IL-6)
189
What is the term for the drug blocking IL-6 in MM?
Siltuximab (anti-IL-6 monoclonal antibody)
190
What is the term for the adhesion molecule mediating plasma cell-bone marrow interaction in MM?
VLA-4 (Very Late Antigen-4)
191
What is the term for the drug targeting VLA-4 in MM?
None currently approved (experimental)
192
What is the term for the proteasome inhibitor used in relapsed/refractory MM?
Carfilzomib
193
What is the term for the exportin-1 inhibitor used in refractory MM?
Selinexor
194
What is the term for the nuclear export protein targeted by selinexor in MM?
XPO1
195
What is the term for the anti-CD38 monoclonal antibody used in MM?
Daratumumab
196
What is the term for the SLAMF7-targeting antibody used in MM?
Elotuzumab
197
What is the term for the combination therapy of lenalidomide and dexamethasone in MM?
Rd regimen
198
What is the term for the triplet therapy adding bortezomib to Rd in MM?
VRd regimen
199
What is the term for the quadruplet therapy adding daratumumab to VRd in MM?
Dara-VRd regimen
200
What is the term for the autologous stem cell transplant conditioning regimen in MM?
High-dose melphalan
201
What is the term for the post-transplant consolidation therapy in MM?
Bortezomib-based consolidation
202
What is the term for the minimal residual disease (MRD) negativity in MM?
No detectable myeloma cells by NGS or flow cytometry
203
What is the term for the rare plasma cell disorder with IgD monoclonal protein?
IgD myeloma
204
What is the term for the even rarer plasma cell disorder with IgE monoclonal protein?
IgE myeloma
205
What is the term for the plasma cell variant with cytoplasmic inclusions?
Mott cells
206
What is the term for the flame-shaped plasma cells seen in IgA myeloma?
Flaming plasma cells
207
What is the term for the test distinguishing kappa and lambda light chains in tissue?
Immunohistochemistry (IHC)
208
What is the term for the genetic test identifying clonal plasma cells?
Clonality testing (e.g.
209
What is the term for the condition where MM cells invade extramedullary sites?
Extramedullary disease (EMD)
210
What is the term for the plasmacytoma occurring outside the bone marrow?
Extramedullary plasmacytoma
211
What is the term for the solitary plasmacytoma in the gastrointestinal tract?
GI plasmacytoma
212
What is the term for the plasmacytoma in the upper respiratory tract?
Nasopharyngeal plasmacytoma
213
What is the term for the rare MM variant with cytoplasmic crystals?
Crystal-storing histiocytosis
214
What is the term for the amyloid deposits in the tongue in AL amyloidosis?
Macroglossia
215
What is the term for the periorbital purpura seen in AL amyloidosis?
Raccoon eyes
216
What is the term for the nephrotic syndrome caused by AL amyloidosis?
Amyloid nephropathy
217
What is the term for the cardiac biomarker elevated in AL amyloidosis?
NT-proBNP
218
What is the term for the treatment combining chemotherapy and stem cell transplant for AL amyloidosis?
High-dose melphalan with autologous stem cell rescue
219
What is the term for the drug targeting amyloid fibril formation in AL amyloidosis?
Doxycycline (experimental)
220
What is the term for the monoclonal antibody targeting amyloid deposits?
None approved (NEOD001 in trials)
221
What is the term for the plasma cell disorder associated with chronic osteomyelitis?
Paget’s disease of bone (not MM
222
What is the term for the osteosclerotic bone lesions in POEMS syndrome?
Sclerotic bone lesions
223
What is the term for the skin changes in POEMS syndrome?
Hyperpigmentation; hypertrichosis
224
What is the term for the endocrine dysfunction in POEMS syndrome?
Hypothyroidism; diabetes mellitus
225
What is the term for the nerve conduction study finding in POEMS syndrome?
Demyelinating polyneuropathy
226
What is the term for the treatment combining radiation and chemotherapy for POEMS syndrome?
Combined modality therapy
227
What is the term for the plasma cell disorder with t(11;14) translocation?
MM with cyclin D1 overexpression
228
What is the term for the drug targeting BCL-2 in t(11;14) MM?
Venetoclax (BCL-2 inhibitor)
229
What is the term for the clinical trial eligibility criteria in MM?
ECOG performance status; organ function thresholds
230
What is the term for the frailty score used in MM treatment decisions?
International Myeloma Working Group (IMWG) frailty score
231
What is the term for the geriatric assessment tool in MM?
GAIN scale (Geriatric Assessment in Hematology)
232
What is the term for the dose-adjusted therapy for frail MM patients?
Reduced-intensity VRd (lenalidomide; bortezomib; dexamethasone)
233
What is the term for the side effect of proteasome inhibitors causing neuropathy?
Bortezomib-induced peripheral neuropathy
234
What is the term for the preventive therapy for bortezomib-induced neuropathy?
Subcutaneous administration; gabapentin
235
What is the term for the cardiac side effect of carfilzomib?
Cardiac failure or arrhythmias
236
What is the term for the pulmonary complication of daratumumab?
Infusion-related reactions
237
What is the term for the pre-treatment to prevent daratumumab infusion reactions?
Corticosteroids; antihistamines; acetaminophen
238
What is the term for the secondary primary malignancy risk in MM patients?
Increased risk of AML/MDS with lenalidomide
239
What is the term for the thromboprophylaxis in MM patients on immunomodulatory drugs?
Aspirin or low-molecular-weight heparin
240
What is the term for the antiviral prophylaxis for herpes zoster in MM patients?
Acyclovir or valacyclovir
241
What is the term for the vaccination strategy in MM patients?
Avoid live vaccines; prioritize pneumococcal; influenza
242
What is the term for the condition mimicking MM with polyclonal plasma cells?
Reactive plasmacytosis
243
What is the term for the infectious cause of reactive plasmacytosis?
HIV; hepatitis C; syphilis
244
What is the term for the autoimmune disease mimicking MM?
Castleman disease
245
What is the term for the lymphoproliferative disorder with IL-6 overproduction?
Multicentric Castleman disease (MCD)
246
What is the term for the anti-IL-6 therapy for Castleman disease?
Siltuximab
247
What is the term for the HHV-8-associated Castleman disease?
HHV-8-positive MCD
248
What is the term for the POEMS-like syndrome without monoclonal protein?
Chronic inflammatory demyelinating polyneuropathy (CIDP)
249
What is the term for the differential diagnosis of MM with bone lesions?
Metastatic cancer; osteoporosis
250
What is the term for the imaging finding distinguishing MM from metastases?
"Punched-out" lytic lesions (MM) vs. sclerotic lesions (metastases)
251
What is the term for the lab test distinguishing MM from MGUS?
Serum free light-chain ratio; bone marrow biopsy
252
What is the term for the prognostic factor in MM related to plasma cell proliferation?
Plasma cell labeling index (PCLI)
253
What is the term for the cytogenetic abnormality t(14;16) in MM?
High-risk translocation
254
What is the term for the fusion gene caused by t(14;16) in MM?
MAF
255
What is the term for the drug targeting MAF in MM?
None approved (experimental)
256
What is the term for the epigenetic modifier dysregulated in t(4;14) MM?
MMSET/WHSC1
257
What is the term for the hypomethylating agent in MM trials?
Azacitidine
258
What is the term for the HDAC inhibitor used in MM?
Panobinostat
259
What is the term for the side effect of panobinostat causing diarrhea?
Severe gastrointestinal toxicity
260
What is the term for the combination therapy of panobinostat with bortezomib?
PANORAMA trial regimen
261
What is the term for the antibody-drug conjugate targeting BCMA in MM?
Belantamab mafodotin
262
What is the term for the ocular toxicity of belantamab mafodotin?
Microcystic keratopathy
263
What is the term for the monitoring required for belantamab mafodotin?
Regular ophthalmologic exams
264
What is the term for the bispecific antibody targeting GPRC5D in MM?
Talquetamab
265
What is the term for the target of talquetamab in MM?
GPRC5D (orphan G protein-coupled receptor)
266
What is the term for the bispecific antibody targeting FcRH5 in MM?
Cevostamab
267
What is the term for the target of cevostamab in MM?
FcRH5 (Fc receptor-like 5)
268
What is the term for the T-cell engager targeting CD3 and GPRC5D?
Talquetamab
269
What is the term for the cytokine release syndrome (CRS) management in CAR-T therapy?
Tocilizumab (anti-IL-6R)
270
What is the term for the neurotoxicity associated with CAR-T therapy?
ICANS (immune effector cell-associated neurotoxicity syndrome)
271
What is the term for the post-CAR-T therapy monitoring for relapse?
MRD assessment via next-generation sequencing (NGS)
272
What is the term for the salvage therapy after CAR-T failure?
Bispecific antibodies; selinexor; venetoclax combinations
273
What is the term for the MM variant with non-secretory status and aggressive course?
Plasma cell leukemia
274
What is the term for the diagnostic criteria for plasma cell leukemia?
≥20% plasma cells in peripheral blood; absolute count ≥2 × 10⁹/L
275
What is the term for the treatment approach for plasma cell leukemia?
Aggressive induction; consider CAR-T or bispecific antibodies
276
What is the term for the MM variant with extensive soft tissue involvement?
Extramedullary myeloma
277
What is the term for the prognostic marker in extramedullary myeloma?
Poor overall survival
278
What is the term for the MM variant with amyloid and myeloma features?
Amyloidoma
279
What is the term for the localized AL amyloidosis without systemic involvement?
Localized amyloidosis
280
What is the term for the smoldering myeloma progressing within 2 years?
High-risk smoldering myeloma
281
What is the term for the trial assessing early intervention in high-risk SMM?
ECOG-ACRIN E3A06 (lenalidomide)
282
What is the term for the precursor condition to AL amyloidosis?
MGUS-associated amyloidosis
283
What is the term for the familial amyloidosis unrelated to plasma cells?
ATTR amyloidosis (transthyretin-related)
284
What is the term for the drug stabilizing TTR in ATTR amyloidosis?
Tafamidis
285
What is the term for the siRNA therapy for ATTR amyloidosis?
Patisiran
286
What is the term for the differential diagnosis of AL vs. ATTR amyloidosis?
TTR gene testing; mass spectrometry of amyloid
287
What is the term for the mass spectrometry-based amyloid typing?
Laser microdissection with tandem mass spec (LMD-MS)
288
What is the term for the rare MM variant with cytoplasmic vacuoles?
Mott cells with Russell bodies
289
What is the term for the Dutcher bodies seen in plasma cells?
Intranuclear pseudoinclusions
290
What is the term for the Auer rod-like inclusions in plasma cells?
None (Auer rods are myeloid-specific)
291
What is the term for the MM variant with t(6;14) translocation?
Cyclin D3 overexpression
292
What is the term for the hyperdiploid MM subtype?
Good-risk MM with trisomies
293
What is the term for the non-hyperdiploid MM subtype?
High-risk MM with IgH translocations
294
What is the term for the MM staging based on serum beta-2 microglobulin?
International Staging System (ISS)
295
What is the term for the ISS Stage I criteria?
β2-microglobulin <3.5 mg/L; albumin ≥3.5 g/dL
296
What is the term for the ISS Stage III criteria?
β2-microglobulin ≥5.5 mg/L
297
What is the term for the R-ISS Stage III criteria?
ISS Stage III + high-risk cytogenetics or LDH >ULN
298
What is the term for the LDH level indicating poor prognosis in MM?
Above upper limit of normal (ULN)
299
What is the term for the high-risk cytogenetics in R-ISS?
del(17p); t(4;14); t(14;16)
300
What is the term for the FISH panel used in MM prognostication?
MM FISH panel (del17p; t(4;14); t(14;16); 1q gain)
301
What is the term for the gain of 1q21 in MM?
High-risk marker associated with proteasome inhibitor resistance
302
What is the term for the loss of 1p32 in MM?
Poor prognostic marker
303
What is the term for the t(14;20) translocation in MM?
Rare; associated with MAFB overexpression
304
What is the term for the MAFB transcription factor in MM?
Driver of plasma cell survival
