Plasma Cell Disorders Flashcards
what is myeloma?
a plasma cell malignancy
what effects can the tumour have in myeloma?
bone lesions hypercalcaemia bone pain marrow failure pancytopenia
what bone lesions are seen in myeloma?
lytic bone lesions
what causes the bone lesions in myeloma?
clonal plasma cells causing focal erosion of bone
what is a potential complication of the bone lesions in myeloma?
compression fractures and spinal cord compression
what effects can the paraproteins have in myeloma?
renal failure
immunosuppression
hyperviscosity
amyloid
what renal disease is seen in myeloma?
cast nephropathy due to light chain deposits
how is myeloma classified?
by the type of antibody produced
what is the median age of diagnosis of myeloma?
65
what is the mainstay of treatment for myeloma?
combination chemotherapy
what drugs can be involved in the chemotherapy in myeloma?
corticosteroids
alkylating agents
novel agents
monoclonal antibodies
name a corticosteroid that may be given in myeloma
dexamethasone
name alkylating agents that may be given in myeloma
clyclophosphamide
melphalan
name novel agents that may be given for myeloma
bortezomib
lenalidomide
name a monoclonal antibody that may be given for myeloma
daratumumab
what can be used to monitor response to treatment in myeloma?
paraprotein levels
what analgesia should be avoided in myeloma?
NSAIDs
what does MGUS stand for?
monoclonal gammopathy of undetermined significance
how is MGUS defined?
paraprotein <30
bone marrow plasma cells <10%
no evidence of myeloma end organ damage
what population group is most commonly affected by MGUS?
older males
what is there a risk of in MGUS?
small risk of progression to myeloma
what causes AL amyloidosis?
mutation in the light chain, resulting in an altered structure
how is AL amyloidosis managed?
chemotherapy to switch off light chain supply
what paraprotein is seen in waldenstrom’s macroglobulinaemia?
IgM paraprotein
what is waldenstrom’s macroglobulinaemia?
a lymphoplasmacytoid neoplasm
how can waldenstrom’s macroglobulinaemia present?
lymphadenopathy
splenomegaly
marrow failure
how is waldenstrom’s macroglobulinaemia managed?
chemotherapy
plasmapheresis
