Myeloma & Lymphoma Flashcards
What is myeloma
cancer of differentiated b lymphocytes known as plasma cells
feautures of acute leukaemia
high proliferative rate
chemosensitive
features of multiple myeloma
- occurs in the over 40
- GMUS - too much immunoglobulin released by abnormal plasma cells
-1% of cases develop into a myeloma
what is multiple myeloma
where the myeloma affects multiple areas of the body
Pathophysiology of myeloma
Plasma cells produce one type of antibody ,
80- Igg
20-1ga
GAMED
when measuring immunoglobulin in patients one will be significantly abundant - more than half the time it is IgG
presentation of multiple myeloma
C- Calcium elevation( thirst)
R- Renal failure
A- Anaemia- fatigue-syncope
B-Bone lesions & pain
risk factors for multiple myeloma
Older age
male
black african ethnicity
fx
obesity
Diagnosis would inolve
FBC- anaemia
ESR- raised
Blood film - rouleaux formation
Urine- bence jones protein
Management of Multiple myeloma
1st line- chemotherapy
stem cell transplant
analgesia
biophosphates
blood transfusions
complications of myeloma
infection
pain
renal failure
anaemia
hypercalcaemia
What is lymphoma
group of cancers that affect the lymphatic system
features of hodgkin lymphoma
-proliferation of lymphocytes in the lymph nodes
- associated with EBV and immunosuppression
- peaks in early 20’s then 70’s
presentation of hodgkin lymphoma
lymphadenopathy - painful upon drinking alcohol
B- symptoms- fever, night sweats, weight loss
How would you make a diagnosis for Hodgkin lymphoma
ESR raised
Imagine CXR/CT for staging
lymph node biopsy - reed sternberg cells
management of Hodgkin lymphoma
ABVD chemotherapy
radiotherapy
steroids
stem cell/bone marrow
transplant
difference between Hodgkin and non Hodgkin lymphoma
Hodgkin is a specific disease whereas non encompasses all other lymphomas
non Hodgkin lymphoma features
- associated with EBV and immunosuppression
- predominantly affects adults over the age of 40
presentation of non hodgkin lymphoma
- painless lymphadenopathy
- B symptoms, weight loss, night sweats , fever
- hepatosplenomegaly
diagnosis for NHL
Imaging for staging
lymph node biopsy - NO REED STERNBERG CELLS
management of NHL
chemo
radiotherapy
Describe the Ann arbor staging for lymphoma staging
Stage 1 -> the disease is in one area only
Stage 2 - the disease is in 2 or more areas on the same side of the diaphragm
Stage 3 -> the disease is in 2 or more areas on both sides of the diaphragm
Stage 4 - the disease has spread beyond the lymph nodes
features of chronic leukaemia
chemo resistant
differentiated myeloid cells would appear on blood film?
perinuclear halo
area of paleness
What is systemic AL amyloidosis
is a protein conformation disorder associated with a subtle clonal plasma cell dyscrasia
presentation of systemic al amyloidosis
oedema
heart failure
how does stem cell transportation work
1- stem cell mobilisation
2- stem cell collection
3- high dose melphalan
4- stem cell transplant
