Myeloma Flashcards
what is myeloma
a plasma cell malignancy
how does myeloma affect the body directly and paraprotein mediated effects
bone lesions
increased calcium
bone pain
replace normal bone marrow - marrow failure
paraprotein mediated effects - renal failure immune suppression hyper viscosity amyloid
how is myeloma classified
by antibody type IgE IgD Biclonal Nonsecretory myeloma BJ myeloma free light chain IgG - most common
what is seen in the bones
multiple pushed out lytic lesions
wedge fractures
hypercalcaemia leads to what
stones bones abd groans psych moans thirst dehydration renal impairment
myeloma and affect on the kidneys
tubular damage by light chains light chain deposition - cast nephropathy sepsis hypercalcaemia and dehydration Drugs; NSAIDs amyliod hyperuricaemia
how many px have renal impairment at diagnosis
30%
how is cast nephropathy treated
damage may be reversible with prompt treatment
switch off light chain production with steroids/chemo
age of onset of myeloma
treatment of myeloma
65
steroids: dexa, pred
alkylating agents - cyclophosphamide, melphalan
thalidomide, bortezomib, lenalidomide
what is used to monitor response in myeloma
paraprotein
symptom control in myeloma
opiate analgesia (avoid NSAIDs)
local radio - good for pain relief and spinal cord compression
bisphosphonates - corrects bone pain and hypercalcaemia
vertebroplasty - inject sterile cement into fractures bone to stabilise
