Hemeonc 15 Flashcards
A malignant proliferation of a single clone of plasma cells in the bone marrow thatsecrete large quantities of a homogeneous immunoglobulin (also called M Protein or M-spike)
multiple myeloma
When you think MM, you should think?!?!
CRAB hyperCalcemia Renal impairment Anemia Bone disease
If your patient has myeloma with elevated proteins, but no CRAB symptoms, what should you do?
Watchfully wait. This is classified as “smoldering” or MGUS
What’s the difference b/t MGUS and smoldering myeloma?
MGUS has 1% per year transformation to myeloma
smoldering has 10%
what age group is most targeted by MM?
> 70
Describe the pathogenesis for MM
1) Infiltration of cancer into bone causing bone reabsorption
2) suppression of normal cells in bone marrow (often pancytopenia)
3) Reduced WBC = infection
4) High levels of M protein = blood viscosity
5) light chains (Benz Jones protein) deposited in kidneys and hypercalcemia cause renal failure
What is the most common symptoms of MM patients? (other than typical cancer complaints)
bone pain, specifically back and chest
Lab results, specific to MM include?
hypercalcemia, high protein, BUN/creatinine elevation (renal failure), increased ESR
What imaging results would raise a red flag for MM?
“punched out” bone lesions
True or False: Multiple myeloma is generally considered to be an incurable disease.
true
What are treatment options for MM?
1) chemo–usually have improvement and plateau before relapse.
2) Drug cocktails
3) transplants occur, but are typically only expected to buy time
4) radiation for symptom control
5) supportive therapy
What is the staging criteria for MM?
Stage I — beta 2 microblobulin <3.5 mg/L and serum albumin ≥3.5 g/dL
Stage II — neither stage I nor stage III
Stage III — B2M ≥5.5 mg/L
what is the life expectancy for MM?
2-5 years, depending on stage
