Paraproteinemia(multiple Myeloma

Question 1

Another name for paraproteins

Answer 1

Monoclonal immunoglobulin and M-protein

Question 2

What are paraproteins

Answer 2

Paraproteins are immunoglobulins that are produced from a single clone of plasma cells

Question 3

Plasma cells produces?

Answer 3

They produce immunoglobulins

Question 4

What are B cells

Answer 4

They are a type of white cells that produces plasma cells

Question 5

What is paraproteinaemia(2 definitions )

Answer 5

1)This is the presence of excessive amount of paraproteins in the plasma
2) This can be defined as an heterogeneous disorder that is characterized by two things
1)proliferation of a single clone of plasma cells
2.presence of excessive amounts of monoclonal protein and its fragments in blood

Question 6

What is the cause of paraproteinaemia

Answer 6

It is usually due to clonal transformation of B cells

Question 7

What are the fragments of monoclonal immunoglobulin

Answer 7

Light chains and heavy chains

Question 8

Diseases associated with paraproteinaemia (6)

Answer 8

1.smouldering myeloma
2.multiple myeloma
3.monoclonal gammopathy of undetermined significance (MGUS)
4.plasma cell leukemia
5.Heavy chain disease
6.waldenstroms macroglobulinaemia

Question 9

Paraproteinaemia can be categorized based on monoclonal protein/fragment found in blood
List the monoclonal fragments and the disease they are associated with

Answer 9

1.light chains only(Bence jones protein)-multiple myeloma and AL amyloidosis(light chains amyloidosis)
2.Heavy chains only(Heavy chains disease )
3.whole immunoglobulins (M protein)

Question 10

Abnormal plasma cell variants (list them)

Answer 10

Mott cell
Flame cells

Question 11

Describe the cytoplasm of Mott cell

Answer 11

Classic “bunch of grapes appearance with ig inclusions(Russell bodies)

Question 12

Mott cell is usually seen in

Answer 12

Plasma dyscrasia (Both the symptomatic and the asymptomatic
Reactive plasmacytoses( There is an increase in the proliferation of plasma cells and it is usually seen in auto immune conditions.e.g Haishimoto syndrome

Question 13

Describe the the flame cell cytoplasm

Answer 13

It resembles red flames
It is commonly seen in IgA myeloma then in IgG and in IgM

Question 14

Immunophenotypes of malignant plasma cells

Answer 14

1.CD38
2.CD138 positive

Question 15

The most common chromosomal abnormality seen in paraproteinaemia

Answer 15

Chromosome 14 t(11:14)

Question 16

The differentials seen in chromosome 14

Answer 16

t(11:14)
t(4:14)
t(14:16)

Question 17

The two chromosomal abnormality and which one has a poor prognosis

Answer 17

Chromosome 13 and chromosome 14
Chromosome 13 has a poor prognosis

Question 18

Roles of cytokines in multiple myeloma

Answer 18

Interleukin 6 is an important mediator in inflammatory response
It is produced after the release of of IL-1 and TNF(tumor necrosis factor)
It is a potent growth factor of myeloma cells
Elevated levels at the time of diagnosis is associated with aggressive disease and poor prognosis
IL-6,IL-1 and TNF are osteoclasts activating factors and mediate osteolytic bone lesions