Multiple Myeloma

Question 1

What is multiple myeloma?

What is the most common primary malignancy of ️bone?

Answer 1

A plasma cell disorder which entails a malignant proliferation of plasma cells @ BM

Multiple myeloma

Question 2

In multiple myeloma what stimulates the growth?

Answer 2

Serum IL6 -> stim plasma growth + Ig production

Question 3

Clinical features of multiple myeloma

Answer 3

Based on what plasma cells are producing

1. Neoplastic plasma cells make osteoclast activating factor ->
   osteoclast activate via RANK -> Eat bone ->
   lytic punched out lesions @ X-ray on vertebrae+skull
   ️bone pain + fracture
2. Neoplastic plasma cells make Ig -> ⬆️serum prot -> mess up charge between RBCs -> rouleaux
3. Also make light chain>heavy chain -> primary amyloidosis
4. Neoplasm of monoclonal plasma cells ->
   make exact same AB -> lose antigenic diversity -> INFECTION

Question 4

If can’t determine cause of increased serum protein what do you do?

Answer 4

Serum Prot ElectroPhoresis - SPEP

albumin band high, alpha 1+2 bands, beta band + GAMMA band

@ multiple myeloma -
get M spike monoclonal Ig - usually IgG>IgA