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Rahmawati Minhajat
A. Fachruddin Benyamin
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= Mieloma Multipel (MM)
= Kahlers disease
= Keganasan sel plasma
* Pendahuluan
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MM = keganasan sel plasma
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Jumlah sel plasma sangat
meningkat
Supresi mielopoesis secr humoral
anemia
keggl SST secr menyeluruh
2. Destruksi tulang
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ok OAF (osteoclast activating
factor)
* nyeri tulang (bone-pain)
* osteo porosis/osteolitik : tl
axial,
calvaria, vertb, prox tl panjang,
iga
* fraktur patologik
3. Sekresi protein
abnormal
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Sel plasma maligna mensekresi
suatu
para-protein = protein M
(abnormal)
Umumnya berbtk IgG atau IgA
sindr.hiperviskositas
3. Sekresi protein
abnormal(2)
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Komponen rantai ringan (light-
chain)
dari Ig gagal ginjal
(kdg2 diperberat oleh
hiperkalsemia)
Katabolisme para-protein
amiloid
gagal jantung & neuropati
* Gbr. klinis
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Peny. lanjut usia (median : 60 th)
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Sindr.hiperviskositas :
perdrh.mukosa,
nausea, vertigo, ggn visus, ggn
jiwa.
Pucat, nyeri tulang, neuropati
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Anemia ( normokrom )
Kyle RA and Rajkumar SV. Cecil Textbook of Medicine, 22nd Edition, 2004
* Terapi
1. Simtomatik (bone-pain dsb)
2. Melphalan/Alkeran +
prednisone
Kombinasi kemotx (alkylating)
3. Radiotx local (nyeri/frakt
patologik)
4. Hindari immobilisasi lama
5. Hindari dehidrasi
* Prognosis
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Median survival : 3 thn