Myeloma Flashcards
What is myeloma?
Neoplastic proliferation of plasma cells in the bone marrow
What is plasmacytoma?
Localised neoplastic proliferation of plasma cells
What are risk factors for myeloma?
Age (older)
Afro-Caribbean ethnicity
FHx
MGUS
What is MGUS?
Monoclonal gammopathy of undetermined significance
Plasma cell proliferation
What is the pathophysiology of myeloma?
Proliferation of plasma cells - either secrete antibodies (IgG) or light chains
Light chains - deposited in the kidney (Bence Jones proteins) = renal failure
Neoplastic cells release cytokines = osteoclast activation = bone resorption + hypercalcaemia
What is the pmneumonic for the features of myeloma?
CRAB
What are the features of myeloma?
Calcium increase
Renal insufficiency
Anaemia
Bone lesions
What are other features of myeloma?
Amyloidosis
- macroglossia
- carpal tunnel
- peripheral neuropathy
Monoclonal antibody proliferation
- recurrent infection
What investigations are done for suspected myeloma?
Urine dip
Bloods
- FBC
- blood film
- U&Es
- bone profile
Whole-body MRI
Bone marrow biopsy
Urine electrophoresis
Serum free light chain assay - kappa + lambda
Serum paraprotein
What do FBCs show in myeloma?
Anaemia
Thrombocytopenia
What does the blood film show in myeloma?
Rouleaux formation
What does the bone marrow biopsy show in myeloma?
> /= 10% plasma cell infiltration
What does urine electrophoresis show in myeloma?
Bence Jones proteins
How is myeloma managed?
Chemotherapy
Bisphosphonates
What are solid tumours in myeloma called?
Plasmacytomas
