Multiple Myeloma Flashcards Preview

Haematology > Multiple Myeloma > Flashcards

Flashcards in Multiple Myeloma Deck (21):
1

what is myeloma

malignancy of plasma cells

2

what are the features myeloma

monoclonal paraprotein in serum +/or urine, bone changes- pain and fractures, excess plasma cells in bone marrow

3

clinical features

bone pain (lower back), pathological fracture, bone marrow failure, infection, renal failure

4

lab features

anaemia, neutropenia, thrombocytopenia.

5

what is the paraprotein in serum

IgG (70%), IgA (20%)

6

what does the bone marrow show

>10% plasma cells

7

further investigations

X ray, CT, MRI shows lytic lesions, osteoporosis

8

what protein is found in the urine

bence jones protein

9

what is CRAB- key features MM

hypercalcaemia, renal failure, anaemia, bony lesions

10

what is a high risk patient who may need early treatment

IgG paraprotein >30g/dl

11

when is chemo indicated

if 1 or more features of CRAB

12

which chemo is used for induction (>65 yrs)

melphalan, prednisolone, thalidomide. bortezomib, lenalidomide

13

when do most patients reach stable plateau phase

4-6 cycles.

14

what treatment for younger patients

cyclophosphamide, dexamethasone, thalidomide followed by high dose chemo

15

do most patients relapse

yes

16

median survival

5-7 years from diagnosis

17

what treatment can be used for relieving pain from skeletal disease

radiotherapy

18

what treatment can be given to patients

allogeneic stem cell transplant

19

other symptomatic management

hydration, allopurinol to prevent hyperuricaemia, bisphosphonates for skeletal. plasma exchange

20

what is benign monoclonal gammopathy (MGUS- monoclonal gammopathy of undetermined significance)

more common than myeloma. low

21

what % MGUS patients go on to develop MM

1%