multiple myeloma

Question 1

major criteria for multiple myeloma

Answer 1

plasmacytoma on tissue biopsy
bone marrow plasmacytosis >30%
M protein: IgG>3.5 g/L; IgA >2.0 g/L
urinary kappa or lambda chain excretion of >1g/24 hours in absence of amyloidosis

Question 2

minor diagnostic criteria for multiple myelom

Answer 2

-marrow plasmacytosis of 10-30%
-lytic bone lesion
-evidence of monoclonal protein but lesser amounts than above
-hypoglobulinaemia of normal protein: IgM<500mg/L, IgA<1g/L, IgG<6g/L

Question 3

myeloma related organ or tissue impairment

Answer 3

CRAB
C: calcium:hypercalcemia: serum cal>0.25mmol/L(>1mg/dL)
R: renal insufficiency: creatinine clearance <40mL per minute or serum creatinine>177
A: anemia: Hb: >20g/L below the lower limit
B: bone lesion one or more osteolytic lesion on skeletal radiography

Question 4

Salmon durie criteria for staging

Answer 4

ABCDE
A: anemia: >10g/dl
B: bone lesion: normal x ray in stage I
C: calcium: <10.5 mg/dl
D: disease mass
E: elevated M component: IgG<5g/dL, IgA<3g/dL

Question 5

ISS staging system

Answer 5

Beta 2 microglobulin <3.5 g/dl
serum albumin >/3.5 g/dl
in stage III
beta 2 microglobulin >/5.5g/dl