Myeloma and Lymphoma Flashcards
damaged light chains in urine called what?
Bence Jones protein
what is MGUS?
monocloncal gammopathy of Undetermined significance
“has the para protein but nothing else”
who gets MGUS?
more likely elderly
why is MGUS important?
more likely to transform to myeloma
does everyone with myeloma have hx of MGUS?
Nope
what do you see in marrow with multiple myeloma?
marrow full of plasma cells?
diagnostic criteria for myeloma?
M-protein in serum/urine
plasmacytoma
end-organ damage: CRAB
what is CRAB?
hypercalcaemia
renal insufficiency
anaemia
lytic bone lesions
what is beta-2 microglobulin?
measures plasma cell burden
but renal impairment alone can raise it
why is multiple myeloma called multiple?
affects multiple bones with lytic lesions ‘pathological fracture’, long bones, spinal
if patient is ill and has high total protein and low albumin, what could it be?
hidden protein (paraprotein)
what kind of lesions on x-ray for multiple myeloma?
lytic lesion
what is the best single agent for treating multiple myeloma?
melphalan
what is immune paresis?
in multiple myeloma, you have a high IgG kappa or lambda, but a very low lgA, IgM
transplant in myeloma is what?
autologous bone marrow, to allow recovery from the strong chemo
thalidomide use these days?
multiple myeloma
someone with paraprotein means myeloma?
Nope, probably MGUS, but watch out for CRAB features
lymphoma by definition is?
malignant
where can lymphoma arise?
liver
spleen
MALT
lymph nodes
2 most common hodgkin
NODULAE SCLEROSIS
MIXED CELLULARITY
classic hodgkin histology?
reid-sternberg cells
mixed infiltrate
B Cell Non hodgkin lymphoms high clinical aggressiveness is?
Burkitt Lymphoma
B Cell Non hodgkin lymphoma intermediate aggressiveness?
diffuse large B cell lymphoma
B Cell Non hodgkin lymphomas low aggressiveness?
follicular lymphoma
grade or stage in Non-hodgkin?
grade (‘nastiness’”
what is stage?
WHERE it is.
non hodgkin lymphoma is grade of stage?
grade
Hodgkin lymphoma grade or stage more predictive?
stage
B symptoms?
weight loss
fever
night sweats
difference between non-hodgkins 1a and 1b stage?
1b has B-symptoms (do worse)
important cut off in hodgkin lymphoma treatment?
up to 2a (get radiotherapy only) after 2b (radio and chemo)
what important biochem marker is elevated in non-hodgkin lymphoma?
LDH
lactate dehydrogenase
non hodgkin grade or stage?
grade
Burkitt lymphoma is what kind of lymphoma?
non hodgkin
what is CHOP?
Cyclophosphamide
Hydroxydornorubicin (Adriamycin)
Oncovin (vincristine)
Prednisolone
Rituximab
Rituximab targets what?
CD20 on B-cells
light chain restriction is what?
restricted to kappa or lambda light chains
