Multiple myeloma Flashcards
what is the abnormal protein produced in multiple myeloma?
M protein
what is the most common heavy chain proliferation in multiple myeloma?
IgG
what are the symptoms of myeloma?
- lytic bone lesions
2. numbness / tingling in lower back / legs
what test is required to view the lytic bone lesions of multiple myeloma?
bone survey
what are the criteria for multiple myeloma diagnosis?
- serum / urine monoclonal protein
- clonal plasma cells in bone marrow
- end organ damage
how is smoldering myeloma different from multiple myeloma?
no end organ damage
how is smoldering myeloma different from MGUS?
for smoldering serum monoclonal protein is greater than 3 g/dL and 10-60% bone marrow clonal plasma cells
what is the mainstay therapy for myelomas?
steroids
what is the overall goal of stem cell transplant therapy?
remission
where are plasmacytomas located?
isolated myeloma mass in bone, most commonly humerus
what is the most common site for extramedullary plasmacytoma?
upper respiratory tract
what are the diagnostic criteria for plasmacytoma?
- biopsy proven solitary lesion of bone or soft tissue with evidence of clonal plasma cells
- bone survey
- absence of end organ damage
what is the treatment for plasmacytoma?
- radiation for bone or soft tissue
2. surgery and/or radiation for extramedullary
definition: amyloidosis
protein conformation disorder associated with clonal plasma cell dyscrasia
what is the clinical feature of amyloidosis?
extracellular deposition of light chain fragments in an abnormal insoluble fibril form
what % of patients with myeloma have concurrent amyloidosis?
10%
what is the diagnosis for amyloidosis?
definitive - congo red stain
what are the screening tests for amyloidosis?
- electrophoresis and urine IF
2. serum free light chains
what is the most important factor for prognosis of amyloidosis?
cardiac involvement
what is the treatment goal for amyloidosis?
retardation of further damage
what are the clinical features of waldenstroms macroglobulinemia?
- excess IgM in blood
2. lymphoplasmacytic lymphoma in marrow
what is the main symptom associated with waldenstroms macroglobulinemia?
hyperviscosity
what is the diagnosis for waldenstroms?
- IgM monoclonal gammopathy (any size)
2. over 10% monoclonal lymphocytes and plasma cell differentiation in bone marrow
what are the treatments for symptomatic waldenstroms?
chemo, plasmapheresis
