Plasma Cell Neoplasms Flashcards Preview

Heme Week 2 > Plasma Cell Neoplasms > Flashcards

Flashcards in Plasma Cell Neoplasms Deck (27):
1

What happens in multiple myeloma?

Expansion of plasma cells in try bone marrow

2

What can be seen in the peripheral blood on MM patients?

Realuex- stacking of red cells due to bridging of abnormal proteins

3

What is an M spike?

in a plasma cell neoplasm you will have a monoclonal proliferation of a single type of immunoglobulin in serum electrophoresis analysis

4

What are some things that need to be evaluated in a patient with newly diagnosed MM?

- CBC with differential
- Chemistry profile
- Calcium levels
- B2-microglobulin
- SPEP, IFX, and quantitative immunoglobulins

5

What is the purpose of a CBC with differential in newly diagnosed MM patients?

determines degree of cytopenias (anemic)

6

What is the purpose of a chemistry profile in newly diagnosed MM patients?

assess renal function

7

What is the purpose of checking calcium levels in newly diagnosed MM patients?

hypercalcemia can occur leading to osteoclastic activity

8

What is the purpose of checking B2-microglobulin in newly diagnosed MM patients?

prognostic factor

9

What is the purpose of checking SPEP, IFX, and quantitative immunoglobulins in newly diagnosed MM patients?

includes serum albumin; IFX is essential to id cases with no M spike

quantitative immunoglobulines can quantitate amount of IgG, igM, IgA, IgD separate from SPEP

10

What is the purpose of checking 24-hr UPEP and IFX in newly diagnosed MM patients?

Bence Jones proteins in urine can damage kidneys

11

How is MM diagnosed

- M protein in serum or urine
- Marrow clonal plasma cells or plasmacytoma
-related organ or tissue impairment

12

What does MM relate in physically?

Calcium-hypercalcemia
Renal insufficiency
Anemia
Bone destruction

13

What does Bone destruction lead to?

-pain
-fractures
-spinal cord compression

14

What does hypercalcemia lead to?

-altered mental status
-renal insufficiency

15

How do MM patients present?

-bone pain
-fatigue
-anemia
-renal insufficiency
-hypercalcemia

16

M-protein on SPE can be seen in what percentage of MM patients?

80%

17

M-peak on IF of serum or urine can be seen in what percentage of MM patients?

97%

18

Most MM is of what immunoglobulin type?

G-50%
A-20%
M-20%
light chain only-15%

19

T or F. Clonal proliferation of plasma cells is a continuum from fairly benign to severe disease

T.

20

What is the first step in the clonal progression?

MGUS- an abnormal clone of plasma cells producing an abnormal immunoprotein but not causing any damage and M protein is pretty small

about 5% over 80 yo have it

21

What is the rate of progression of MGUS to monoclonal B cell malignancy?

1%/yr

22

One step up from MGUS is what?

Smoldering myeloma

23

How is Smoldering myeloma defined?

M-protein in serum greater than 30g/L (3mg/dl) and/or BM clonal plasma cells over 10%

No related organ or tissue impairment or symptoms (No CRAB)

24

One step up from smoldering myeloma is what?

symptomatic MM

25

How is symptomatic MM defined?

- presence of M-protein in serum and/or urine

related organ or tissue impairment

26

How does MM cause bone disease?

-myeloma cells produce DKK1, leading to increase in RAKL and iL6 by osteoblast progenitor cells

27

Increased in RANKL and IL6 causes what?

-osteoblast differentiation is blocked and osteoclast maturation is stimulated