Plasma Cell Dyscrasias

Question 1

plasma cell markers

Answer 1

CD38, CD138
IL-6
multiple cytogenetic changes

Question 2

M-spike

Answer 2

on SPEP or UPEP

indicates monoclonal gammapathy

Question 3

when would you see a polyclonal gammopathy?

Answer 3

infectious, inflammatory or reactive state

Question 4

Other name for free light chains in UPEP

Answer 4

Bence-Jones proteins

Question 5

monoclonal gammopathy of undetermined significance

Answer 5

m-spike finding without any other criteria for MM or other dyscrasias
- no lytic lesions or CRAB symptoms
- less than 10% plasma cells in bone marrow
higher likelihood to develop a hematologic disorder

Question 6

CRAB symptoms

Answer 6

C- hypercalcemia
R - renal failure
A - anemia
B - bone lesions

Question 7

diagnostic criteria for multiple myeloma

Answer 7

M protein in serum and/or urine (usually IgG or IgA)
10% or more clonal bone marrow plasma cells
End organ impairment (CRAB symptoms)

Question 8

natural hx of MM

Answer 8

7 months w/out tx
3-5 yrs w/ tx
not curable

Question 9

MM tx

Answer 9

chemos - alkalating agents and prednisone
proteasome inhibitor 
thalidomide and lenalidominde
radiation
autologous transplant

Question 10

Waldenstrom macrogobulinemia

Answer 10

IgM paraprotein
hyperviscosity symptoms b/c IgM is so big
tx: rituxin, chemo, steroids, immunomodulators

Question 11

amyloid AL

Answer 11

light chains deposited in tissue (congo red stain)
survival 4-6 months w/ cardiac involvement
rx like myeloma