Multiple Myeloma Flashcards
What is Multiple Myeloma?
Neoplastic proliferation of plasma cells and accumulation of immunoglobulin-secreting cells derived from B-cell lymphocytes.
Where do plasma cells originate from?
Plasma cells originate from B-cell lymphocytes, which develop from stem cells found in all tissues of the body.
What characterizes Multiple Myeloma?
It is characterized by neoplastic proliferation of a single clone of plasma cells.
What do plasma cells produce in Multiple Myeloma?
They produce a monoclonal protein that leads to the destruction of bone.
Can Multiple Myeloma be asymptomatic?
Yes, it may remain asymptomatic for years.
What is the most common age group affected by Multiple Myeloma?
It is most common in those that are 65 years old.
What is a significant risk factor for developing multiple myeloma related to age?
The risk of developing multiple myeloma increases as people get older. Most people diagnosed with this cancer are at least 65 years old.
Which gender is more likely to develop multiple myeloma?
Men are slightly more likely to develop multiple myeloma.
How does race affect the risk of developing multiple myeloma?
Multiple myeloma is more than 2 times as common in African Americans than in white Americans.
The reason is unknown.
What is the genetic risk factor for multiple myeloma?
Multiple myeloma seems to run in some families. Someone who has a sibling or parent with myeloma is more likely to get it than someone who does not have a family history.
What type of exposure is a risk factor for multiple myeloma?
Chemical exposure is a risk factor for developing multiple myeloma.
How does obesity affect the risk of multiple myeloma?
Being overweight or obese increases a person’s risk of developing myeloma.
What does multiple myeloma cause?
Multiple myeloma causes bone loss, resulting in painful bony lesions.
What causes bone loss in multiple myeloma?
The loss of bone is caused by a disruption in the process of bone formation and resorption.
What are common complications of multiple myeloma?
Patients may have pathologic fractures and hypercalcemia.
How does multiple myeloma differ from other primary bone tumors?
Hypercalcemia sets this disease apart from other primary bone tumors.
What percentage of patients with multiple myeloma experience pathologic fractures?
Nearly 60% of patients with multiple myeloma have pathologic fractures at some point.
What does CBC stand for in the context of Multiple Myeloma detection?
CBC stands for Complete Blood Count, a test that measures the levels of red cells, white cells, and platelets in the blood.
What is the most common finding in a CBC for Multiple Myeloma?
The most common finding is low red blood cell count, also known as anemia.
What is the purpose of a Urine Analysis in Multiple Myeloma diagnosis?
A Urine Analysis is typically taken to look for myeloma protein that has filtered through the kidneys.
What does a Bone Marrow biopsy help determine in Multiple Myeloma?
A Bone Marrow biopsy helps determine the presence of myeloma cells in the bone marrow.
What imaging technique can detect bone destruction caused by myeloma cells?
X-ray can detect bone destruction caused by myeloma cells.
What is a bone survey or skeletal survey?
A bone survey or skeletal survey is a series of x-rays that includes most of the bones.
What is a common issue with bone scan results in Multiple Myeloma?
Bone scan results are often negative and may underestimate the extent of the disease.
What can a radiograph show in patients with Multiple Myeloma?
A radiograph may show the number of lesions and whether a pathologic fracture is present.
What is an indicator of multiple myeloma in imaging?
If a patient has multiple bone lesions without a known primary tumor site.
What role do healthy plasma cells play in the body?
Healthy plasma cells help fight infections by making antibodies that recognize and attack germs.
What happens to plasma cells in Multiple Myeloma?
In Multiple Myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells.
Where can pathologic fractures occur in Multiple Myeloma?
Pathologic fractures can occur in any bone and are characterized by osteolytic lesions shown on diagnostic radiographs.
What is a common consequence of osteolytic lesions in Multiple Myeloma patients?
The presence of osteolytic lesions limits the healing process in most patients, commonly leading to pathologic fractures.
What staging system is used for multiple myeloma?
Revised international Staging System
What is the typical treatment for multiple myeloma?
A combination of chemotherapy and radiation therapy. Surgery is uncommon.
What is the intent of chemotherapy in multiple myeloma treatment?
Given with a curative intent.
What are common chemotherapy agents used for multiple myeloma?
Melphalan and prednisone.
What is Bortezomib?
A proteasome inhibitor and radiosensitizer.
What is Thalidomide used for in multiple myeloma treatment?
An immunomodulatory agent used to boost immune function.
How is radiation therapy effective in multiple myeloma?
Effective in controlling localized pain from a bony lesion.
What is the purpose of high dose chemotherapy and radiation therapy in multiple myeloma?
To prepare the patient for stem cell transplantation.
What is becoming a common treatment regimen for multiple myeloma?
Autologous stem cell transplant after high dose chemotherapy and radiation therapy.
What age group is currently preferred for autologous stem cell transplant?
Patients younger than the age of 60 years.
When is radiation used in multiple myeloma treatment?
To treat areas of bone damaged by myeloma that have not responded to chemotherapy and/or other drugs.
What is the effective dose of radiation for controlling pain in multiple myeloma?
A dose of 30 Gy, typically administered in 10 to 15 treatments.
What should be considered when planning radiation treatment for lesions?
The entire lesion must be treated with generous margins for osteolytic lesions.
What chemotherapy drugs are used for multiple myeloma?
Melphalan and prednisone
Bortezomib
Thalidomide
What happens if myeloma severely weakens the vertebral bones?
The bones can collapse and put pressure on the spinal cord and spinal nerves.
What are the symptoms of weakened vertebral bones due to myeloma?
- Sudden change in sensation such as numbness or tingling
- Sudden weakness of leg muscles
- Sudden problems with urination or moving the bowels
Why is prompt treatment with radiation therapy needed in myeloma cases?
To prevent paralysis.
What is a common dose of radiation therapy delivered to relieve bone pain in myeloma?
30 Gy.
What is total body irradiation (TBI) used for?
It is used in treating several diseases, including multiple myeloma, leukemias, lymphomas, and some solid tumors.
What is TBI most commonly used for in combination with chemotherapy?
As part of the conditioning regimen prior to hematopoietic stem cell transplantation.
What areas does TBI penetrate that traditional chemotherapy is ineffective against?
It penetrates areas such as the central nervous system and testes.
What are the three purposes of TBI?
- Eliminate residual cancer cells
- Provide space for stem cell engraftment through bone marrow depletion
- Prevent rejection of donor stem cells through immunosuppression.
What is the most common dose schedule for myeloablative TBI?
2-8 Gy in 1-4 fractions or 15 Gy in 8-12 fractions over 4 days with 2 to 2.5 treatments daily.
