Multiple Myeloma (Exam 3)

Question 1

MGUS

Answer 1

M protein present, chance of progressing to mutiple myeloma. M protein below 3g/dL and less than 10% plasma cells in bonemarrow.

Question 2

Mutiple Myeloma

Answer 2

Cancer of plasma cells, my protein present in serum and urine. 4:100k more in african american males. Average age 65. Predominately IgG followed by IgA.

Question 3

Smoldering Multiple Myeloma

Answer 3

M protein above 3 g/dL and or more than 10% plasma cells in bonemarrow. No end organ damage.

Question 4

High risk translocation

Answer 4

17p deletion 14;16 and 14;20

Question 5

Intermediate risk translocation

Answer 5

4;14 and 13 deletion or hypodiploidy by conventional karyotyping

Question 6

Standard risk

Answer 6

Trisomies, 11;14 and 6;14

Question 7

Mutiple myeloma treatment

Answer 7

Chemo, steroids, immunomodulators, bone marrow transplant (auto), and bisphosphonates/radiation.

Question 8

Stem cell transplant in MM

Answer 8

Prolongs survival by 13 months on average, auto only

Question 9

Plasmacytoma

Answer 9

Isolated mass of plasma cells, can have low levels of M protein. Might have light chain elevation. When its in the bone its harder to treat. Tx: radiation in bone, resection outside.

Question 10

Amyloidosis

Answer 10

Protein conformation disorder associated with plasma cell dyscrasia. Proteins deposit in the organs. 10% of patients with Myeloma have concurrent amyloidosis.

Question 11

Amyloidosis Diagonosis

Answer 11

Congo red Staine with red green under polarized light.

Question 12

Amyloidosis Prognosis

Answer 12

Cardiac involvement is a median survival of 6 mo.

Question 13

Amyloidosis treatment

Answer 13

CyBorD, restrict further deposition

Question 14

Waldenstroms macroglobulinemia

Answer 14

Excess igM and lymphplasmacytic lymphoma in marrow. Only treat if symptomatic, chemo. Incurable.