Multiple Myeloma

Question 1

What is Multiple Myeloma?

Answer 1

XS proliferation of Plasma Cells in marrow.

Most common haematological cancer.

Question 2

Pathology of Multiple Myeloma?

Answer 2

Abnormal Plasma cells infiltrate marrow (destruction) and/or form masses = myelomas

Question 3

Presentation of Multiple Myeloma?

Answer 3

1) Initially Asymptomatic
2) ‘CRAB’ signs
Calcium elevated
Renal failure
Anaemia
Bone pain/lesions on imaging

Question 4

Bedside investigations for Multiple Myeloma?

Answer 4

Serum calcium - Raised Ca
U&Es - Renal failure
FBC - Normocytic Anaemia (Chronic Disease)

Question 5

Additional Investigations to confirm diagnosis?

Answer 5

Blood film - Roleaux sign (RBC aggregation)

Urine electrophoresis - Bence Jones protein

Question 6

Imaging for Multiple Myeloma?

Answer 6

Skeleton survey: X-Ray for bone lytic lesions

Question 7

Managing Multiple Myeloma?

Answer 7

1) Chemotherapy 12-18 months.

2) Conservative (e.g. painkillers, rehydration, transfusion)