multiple myeloma

Question 1

what are the investigations for multiple myeloma

Answer 1

• Blood film – rouleaux formations (stacked RBC)
• Urine electrophoresis – Bence Jones protein
• Bone marrow aspirate – plasma cell infiltration percentage
• X-rays – lytic lesions e.g. raindrop/pepper-pot skull

Question 2

What are the sign of multiple myeloma

Answer 2

hypercalcemia
Renal impairment
Anaemia
Bone pain (commonly as backaches)

Question 3

how is multiple myeloma diagnosed

Answer 3

• 2 of
• Paraproteinemia OR Bence-Jones protein
• Radiologic evidence of lytic lesions e.g. pepperpot skull
• Increase in bone marrow plasma cells >30%
• > 1g light chains excreted/day
• Serum monoclonal Ig OR urine monoclonal light chains (on electrophoresis)

Question 4

management’s of multiple myeloma

Answer 4

chemotherapy
* Bortezomib
* Thalidomide
* Dexamethasone

Stem cell
* Autologous (own stem cells)
* Allogeneic (donor’s stem cells)

For fitter pattients
* Bisphosphonates may be used to suppress osteoclast activity to alleviate bone pain
* Kyphoplasty is a surgical option for pathological fractures.