Multiple Myeloma Flashcards
what is myeloma
malignancy of plasma cells
what are the features myeloma
monoclonal paraprotein in serum +/or urine, bone changes- pain and fractures, excess plasma cells in bone marrow
clinical features
bone pain (lower back), pathological fracture, bone marrow failure, infection, renal failure
lab features
anaemia, neutropenia, thrombocytopenia.
what is the paraprotein in serum
IgG (70%), IgA (20%)
what does the bone marrow show
> 10% plasma cells
further investigations
X ray, CT, MRI shows lytic lesions, osteoporosis
what protein is found in the urine
bence jones protein
what is CRAB- key features MM
hypercalcaemia, renal failure, anaemia, bony lesions
what is a high risk patient who may need early treatment
IgG paraprotein >30g/dl
when is chemo indicated
if 1 or more features of CRAB
which chemo is used for induction (>65 yrs)
melphalan, prednisolone, thalidomide. bortezomib, lenalidomide
when do most patients reach stable plateau phase
4-6 cycles.
what treatment for younger patients
cyclophosphamide, dexamethasone, thalidomide followed by high dose chemo
do most patients relapse
yes
