plasmacelldyscrasias Flashcards
what are some plasma cell dyscasias
MGUS, multiple myeloma, plasmacytoma, amyloidosis, waldenstroms macroglobuninmia
what is a multiple myeloma
cancer of plasma cells that produce antibodies and immune function. Looking for a monoclonal cancer M cell common in males, AA ad over 65.
what is mgus
monoclonal gammopathy of undetermined significance we dont know what is causing it. Precancerous condition no symptoms 1% chance per year of becoming a myeloma.
what are the symptoms of myeloma
various body systems, bone/fractures numbness/tingling in the lower back/legs , wieght loss, weakness altered mental status, short breath fatigue unrinary issues.
tell me about the chains in myelomas
IgG most common and then IgA d and e are rare, in the heavy chains and kappa and lambda are the light chains third most common in the light chain only myeloma. EX: IgG Kappa or IgA lambda
how do you diagnoses multiple myeloma
presence of serum or urinary monoclonal protein more than 3% in the blood, and presence of clonal plasma cells in the bone marrow greater than 10%, and presence of end organ damage such as calcium concentration lytic bone lesions anemia or renal failure, you need all three of these to diagnos this.
what is smoldering myeloma
when you do not have the end organ damage but the other two symptoms
what is the staging of multiple myeloma
Stage 1 B2M [meta 2 microglobulin test] less than 3.5 and serum albumin more than 3.5, stage 2 neither stage 1 or 3, stage 3 B2M more than 5.5, prognosis per stage 1. 62, 2. 44, 3. 29 months.
what are the cytogenetics for multiple myeloma
Chromosome 14 for the heavy chains and a mutation or trans-location will change the risk and prognosis.
how do you treat multiple myeloma
smoldering just wait and watch, normal myelomas, chemo steroids immunomodulators, bone marrow transplant and bisphosphonates and radiation.
what is the screen for amylodosis associated with multiple myeloma
Congo red stian is the definitive test but you can also do MPEV but absence does not mean its not there.
what is amylodiosis
protein confomation disorder asociaed with clonal plasma cell dyscrasia, extracellular deposition of light chain fragments in abnormal insoluble form.
what percent of patients with myeloma have amyloidosis
10% most common in the kidney heart liver periorbital
what are the prognostic factors of amyloidosis
Cardiac 6 months, most important factor is if its in the heart. But also poor if in the liver.
what is the treatment of amyloidosis
treatment aid is to retard further deposition because you cannot cure it.
