Multiple Myeloma Flashcards
multiple myeloma things you must know
Monoclonal plasma cell proliferation
Monoclonal gammopathy
Decreased normal immunoglobulins
Osteolytic lesions
laboratory findings MM
M-spike
Bence-Jones protein in urine
Decreased normal Ig
Ig increased
type of Ig in MM
IgG in 60% of cases
IgA in 20% of cases
IgD or IgE in rare cases
Never IgM
morphology MM
blood - anemia, rouleaux
marrow - plasma cells, amyloid
bence jones protein
light chains of monoclonal Ab small enough to end up in urine
russell bodies
in bone marrow
making ig but can’t get out of cell quick enough - cytoplasmic inclusions containing ig
mott cell
plasma cell with many russell bodies
dutcher body
russell body in the nucleus
Waldenström macroglobulinemia
Lymphoplasmacytoid lymphoma
IgM
Hyperviscosity syndrome (often retinal presentations)
MGUS (Monoclonal gammopathy of undetermined significance)
Small M spike with no myeloma symptoms
Occasionally transforms into myeloma
biology of normal plasma cells
plasmablasts in lymph nodes –> activated B cells in Bone marrow –> differentiate into plasma cells (small in number, well differentiated, characteristic phenotype, die by apoptosis)
biology of malignant plasma cells
plasmablasts in lymph nodes –> plasmablasts in bone marrow –> do not differentiate, continue to proliferate and accumulate in marrow, produce large amts of ig, normal death of cells doesn’t occur, crows out other cells, suppress ab synthesis by normal plasma cells
clinical features
bone pain - multiple lytic lesions bruising or bleeding from dec platelets infections hypercalcemia renal failure hyperviscosity syndrome
major causes of death from mm
infection, renal failure
classic triad MM
anemia, bone pain, renal failure
