1. low tumour mass 2.intermediate tumour mass 3. high tumour mass

MM Flashcards by Maryam Garkuwa

WHAT IS MM

cancer of b cellls (plasma cells)

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what kind of antibodies are secreted

mostly IG G type

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epidemiology

elderly just like cll

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m protein

An antibody found in unusually large amounts in the blood or urine of people with multiple myeloma

stands for monocolal

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what is the effect of having so many antibodies

they are uselss and makes the blood really viscous causing problems like visual, headaches clots

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symptoms

pneumonic

bONE PAIN
PATHOLOGIC FRACRYRE and vertenra compression
RECURRENT INFECTION

CRAB HAI

-hypercalcemia
renal impariemtns
hyperviscsty
amylodioss

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why is renal damage a thing

because hypercalcemia causes renal damage! and also the depostion of light chains

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what type of AMYLOIDOSI

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DIAGNOSIS

x ray- look at osteolytic lesions common words is ‘punched out lesions’

bloods- anemia , u&E renal failure , hypercalcemiA
NB- ESR OVER 100

urine - bence jones proteins

electrophoresis of urine will show paraprotein spike

bM aspiration if 10 % of cells are plasma cellls

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b2 microglobilin is used in which cancers

CLL, lymhomas , MM

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THERE IS A CORRELATION WITH B 2 MICROGLOBLIN AND

kidney problems so the higher the level the higher the kindey issues

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staging is

durie and salmon

INTERANTIONAL STAGING SYSTEM

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what does the staging classifcation look at

HB levels
calcium levels
bone lesiosn
creatinin levels >2 or <2

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durie and salmon

low tumour mass

2.intermediate tumour mass

high tumour mass

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how to treat the hypercalcemia

calcitonin

bisphophonates

diueretics

CS- they increase urinary excretion and decrease gut absorption

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what is the similarities of CLL and mM

NOT EVERY PATIENT REQUIRES TX

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INTERNATIONAL STAGIG YSTSEM

looks at b2 microglobulin levels

albumin level

3 stages

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rituximab marker

CD 20

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what do we use ritubximan in

NON HODGKIN LYMPHOMA AND CLL

THE NAME OF BIOLOIGCAL TX IN MM and marker

Daratumumab CD38

whats the NB for diagnosi of mm

ESR IS VERY IMPORTANT >100 very typical

<65

autologous stem cell transplant or allogenic (selected cases)

and biological agents too

<65

autologous (more common) stem cell transplant or allogenic (selected cases)

what can we give for the bones

bisphosphonates such as zoledronic acid

denosumab - monocloanal ab

3 musketeers of drugs

bartesomib thalidomide lenalidomide

whats importnat in the tx of mm

corticosteroids, monoclonal antibodies,

supportive management

analgesisc biphosphantes EPO anemia

what issues does hyperviscosity show

headaches, visual impairemnt clots

why is the blood viscouse

extra prtoeins

what is waldenstrom

cancer of b cells lik mm

importnat thing to do with MM NB

FISH

PROGNOSTIC FACTORS

B2 ALBUMIN

What findings would you expect on bone marrow aspiration in myelofibrosis?

a dry tap

What finding on bone marrow would you expect in multiple myeloma?

w biopsy will reveal >10% plasma cells in the bone marrow

diagnosis criteria

1. M protein 2. bm biopsy

rhyme associated with hypercalcemi a

bones, stones, groans and moans

symptoms of hypercalcemia

cosntipated vommiting !!!!! peeing a lot (flush out) bone pain moods

what can we specifcially see with the blood cells

reoleux formation

whats the diff between waldenstrom and multiple myeloma

mM- PLASMA W- B CELLS

whats the diff between waldenstrom and multiple myeloma

mM- PLASMA W- B CELLS

MGUS

what radiological finding do we see with the skull

raindrop skull

roleux is associatiated with

maliganacy and infection

bone pain in mm

and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement

most common symptom

is bone pain

steps for transplane

1. induction 2. conditioning with melephan 3. transplant