Haematology 9 - Myeloma

Question 1

define myeloma

Answer 1

cancer of the plasma cells

Question 2

define MGUS

Answer 2

blood results with features of myeloma but no symptoms

Question 3

define smouldering myeloma

Answer 3

higher levels of Abs or antibody components than in MGUS so higher risk of transformation

Question 4

what are the features of myeloma x4 ?

Answer 4

CRAB

high calcium
renal failure
anaemia
bone lesions + pain

myeloma infiltrates the bones
renal failure due to blockage of tubules by Ig + calcium impacts

Question 5

testing for myeloma, general blood tests

Answer 5

FBC (low WBC)
calcium (high)
ESR (raised)
plasma viscosity raised

Question 6

confirmatory tests for myeloma

Answer 6

need multiple to be positive

urine electrophoresis (Bence Jones proteins)
serum free light chain assay
serum Igs
serum protein electrophoresis

BM biopsy definitive

Question 7

x ray myleoma signs

Answer 7

punched out lesions
lytic lesions
pepperpot skull

Question 8

managing myeloma

Answer 8

MDT

thalidomide
dexamethasone
bortezomid

VTE prophylaxis

may need bone surgery + bisphosphonates too

Question 9

complications of myeloma

Answer 9

renal failure
high calcium
peripheral neuropathy
spinal cord compression