Myeloma Flashcards
What is myeloma?
It is a cancer of plasma cells, which are a type of B lymphocyte that produce antibodies. So you get a single type of an antibody being produced.
What percentage of cancers does myeloma account for?
1%
What is multiple myeloma?
Where the myeloma affects multiple areas of the body .
What is the brief pathophysiology of myeloma?
Plasma cells rapidly proliferate due to a genetic mutation. These plasma cells produce a single type of immunoglobulin. This is referred to as a monoclonal paraprotein
Why is anaemia caused in myeloma?
Bone marrow infiltration with plasma cells which causes suppression or other blood cell lines that leads to anaemia, neutropenia and thrombocytopenia.
What is myeloma bone disease?
It is as a result of increased osteoclast activity. And decreased osteoblast activity so bone metabolism becomes unbalanced. This is caused by stromal cells releasing cytokines due to contact with plasma cells.
What are some common places for myeloma bone disease to occur?
Skull, spine, the long bones and the ribs.
NB: the abnormal bone metabolism is patchy meaning that in some areas the bone is very thin and in some areas its fine.
What are patches of abnormal bone metabolism in myeloma referred to as?
Osteolytic lesions
What happens as a result of the abnormal bone metabolism?
A lot of calcium is released into the blood causing hypercalcaemia.
Why does myeloma cause renal disease?
- High level of immunoglobulins block the flow through the tubules and clog up the kidneys.
- Hypercalcaemia thats caused by myeloma bone disease can also cause damage to the kidneys
When does plasma viscosity increase?
When there are more proteins in the blood
When does plasma viscosity increase?
Plasma viscosity increases when there are more proteins in the blood. These are proteins like immunoglobulins and fibrinogen, both of which increase with inflammation. In myeloma there are large amounts of immunoglobulins in the blood causing the plasma viscosity to be significantly higher.
What might a raised plasma viscosity cause?
- Easy bruising
- Easy bleeding
- Reduced or loss of sight due to vascular disease in the eye
- Purple discolouration to the extremities (purplish palmar erythema)
- Heart failure
What are the symptoms of Myeloma?
C – Calcium (elevated)
R – Renal failure
A – Anaemia (normocytic, normochromic) from replacement of bone marrow.
B – Bone lesions/pain
What are the risk factors for myeloma?
- Older age
- Male
- Black African ethnicity
- Family history
- Obesity
