Other Blood Cancers/Diseases

Question 1

Answer 1

Multiple Myeloma Bone Marrow Biopsy

• Characterized by large plasma cells with large nucleoli
• plasma cells must be >10% of marrow cellularity

Question 2

Answer 2

Multiple Myeloma Peripheral blood

• Rouleaux

Question 3

What is MGUS?

Answer 3

Monoclonal Gammopathy of Undetermined Significance

• Precursor to multiple myeloma
• <10% plasma cells in marrow
• no end organ damage

Question 4

What are the common symptoms of multiple myeloma?

Answer 4

hyperCalcemia

Renal failure

Anemia

Bony lesions

Question 5

What is the test for multiple myeloma?

Answer 5

Test for monoclonal protein in the urine or serum by electrophoresis (SPEP or UPEP). Usually IgA or IgG

• >3 g/dL

Question 6

Multiple Myeloma pathogenesis

Question 7

Polycythemia Vera pathogenesis

Answer 7

Activating mutations in JAK2 that result in the overproduction of RBCs without stimulation from growth factors such as EPO

Question 8

Polycythemia Vera clinical presentation

Answer 8

Symptoms are due to increased RBC mass

• plethoric complexion
• VTE, MI, stroke, etc
• itching exacerbated by hot showers
• erythromelalgia - burning sensation in the hands or feet

Question 9

Polycythemia Vera workup

Answer 9

• Diagnosis requires elevated HCT and evidence of JAK2 mutation
• low Epo level
• Bone marrow hypercellular
• peripheral blood with erythrocytosis, graulocytosis, basophilia, thrombocytosis

Question 10

Polycythemia Vera Treatment

Answer 10

phlebotomy

gentle chemotherapy (hydroxyurea)

aspirin

Question 11

Polycythemia Vera Diagnostic Criteria

Answer 11

Question 12

What does this CBC suggest?

Answer 12

PV

Question 13

Answer 13

PV bone marrow

• hypercellular marrow with trilineage proliferation and pleomorphic megakaryocytes