Multiple Myeloma Flashcards
What is myeloma?
Myeloma is a haematological cancer affecting the plasma cells of the bone marrow
What are plasma cells?
Differentiated B lymphocytes that produce antibodies
What is multiple myeloma?
Myeloma that affects multiple areas of bone marrow in the body
What is produced in myeloma?
Large amounts of a paraprotein (or M protein)
What are paraproteins in myeloma?
Abnormal antibodies or parts of antibodies produced by rapidly multiplying plasma cells
What are Bence-Jones proteins?
Free light chains in the urine
What are the features of multiple myeloma?
CRAB
- Hypercalcaemia
- Renal failure
- Anaemia
- Bone lesions and bone pain
What is the main reason for renal failure in myeloma?
Light chains are deposited within the renal tubules
Why does anaemia occur in multiple myeloma?
Crowding of the bone marrow suppresses erythropoeisis
What kind of anaemia is seen in multiple myeloma?
Normocytic, normochromic anaemia
What are the risk factors for myeloma?
Older age
Male
Black ethnic origin
Family history
Obesity
What investigations are useful in the diagnosis of myeloma?
FBC - anaemia, leukopenia
Calcium - raised
ESR - increased
Plasma viscosity - increased
U&E - renal impairment
Urine protein electrophoresis - Bence-jones proteins
Serum protein electrophoresis
What investigation is used to confirm the diagnosis of myeloma?
Bone marrow biopsy
What imaging is used in myeloma to assess for bone lesions?
First choice - whole body MRI
Second choice - whole body low-dose CT
Third choice - Skeletal survery (XR of whole body)
What XR findings are consitent with myeloma?
Well-defined lytic lesions
Diffuse osteopenia
Abnormal fractures
