Multiple myeloma

Question 1

What is MM?

Answer 1

Unregulated proliferation of plasma cells in the bone marrow- 90% secrete monoclonal Ab. Single IgG/A class called paraprotein.

Can follow preceding MGUS.

Question 2

MM symptoms?

Answer 2

CRABI
Calcium- hypercalcaemia to to resorption
Renal- light gain Ab deposition in renal tubules -> renal impairment
Anaemia- fatigue and pallor, easy bleeding
Bones- lytic bones lesions, pathological fractures.
Infections

Question 3

MM- blood results

Answer 3

Anaemia
Thrombocytopenia
Raised U+Es, raised Ca2+
Serum protein electrophoresis- monoclonal IgA/IgG.
Urine protein electrophoresis- Bence Jones Proteins

Question 4

MM- treating.

Answer 4

Chronic relapsing and remitting malignancy, no cure.

Autologous stem cell transplant available- induction meds: Bortezomib and dexamethasone.

No transplant: Thalidomide, alkylating agent + dexamethasone.