multiple myeloma

Question 1

what is multiple myeloma

Answer 1

neoplastic disorder of plasma cells - results in monoclonal bands = paraproteins and excessive production of a single type of immunoglobulin (Ab)

Question 2

aetiology of MM

Answer 2

peaks 70yo

blacks > whites

Question 3

Pathology of MM

Answer 3

due to plasma proliferation - can lead to bone marrow infiltration /failure

or paraproteins can thicken blood

Question 4

signs and symptoms of MM

Answer 4

bone pain (bone marrow invasion)

anaemia

hyper viscosity syndrome

recurrent infections

bleeding tendency

renal faillure

cord compression (paraspinal mass)

Question 5

tests for MM

Answer 5

urine and serum for excessive amounts of paraprotein

Question 6

tx for MM

Answer 6

Chemotherapy
o cyclophosphamide, thalidomide and dexamethasone
o Proteasome inhibitor, IMiDs (immunomodulator drugs), monoclonal antibodies (in trials)

Bisphosphonate therapy
o Zoledronic acid

Radiotherapy – effective

Surgery
o Pinning of long bones; decompression of spinal cord

Autologous stem cell transplant
Disease under control, withdraw some bone marrow – final dose of chemo then infuse autologous stem cell back