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  • MULTIPLE MYELOMA - PPSX

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    MJ Putra
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    Multiple myeloma is a cancer of plasma cells that results in excessive production of abnormal proteins. Key characteristics include increased plasma cells in the bone marrow, bone destruction causing pain and fractures, and secretion of paraprotein causing complications like hyperviscosity syndrome, kidney damage, and amyloidosis. Diagnosis is based on blood tests showing anemia, high calcium, and monoclonal paraprotein on serum protein electrophoresis. Treatment involves chemotherapy, steroids, radiation, and symptom management. Prognosis depends on factors like extent of organ damage and tumor burden, with median survival around 3 years.

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    Multiple myeloma is a cancer of plasma cells that results in excessive production of abnormal proteins. Key characteristics include increased plasma cells in the bone marrow, bone destruction causing pain and fractures, and secretion of paraprotein causing complications like hyperviscosity syndrome, kidney damage, and amyloidosis. Diagnosis is based on blood tests showing anemia, high calcium, and monoclonal paraprotein on serum protein electrophoresis. Treatment involves chemotherapy, steroids, radiation, and symptom management. Prognosis depends on factors like extent of organ damage and tumor burden, with median survival around 3 years.

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    10 views16 pages

    MULTIPLE MYELOMA - PPSX

    Uploaded by

    MJ Putra
    Multiple myeloma is a cancer of plasma cells that results in excessive production of abnormal proteins. Key characteristics include increased plasma cells in the bone marrow, bone destruction causing pain and fractures, and secretion of paraprotein causing complications like hyperviscosity syndrome, kidney damage, and amyloidosis. Diagnosis is based on blood tests showing anemia, high calcium, and monoclonal paraprotein on serum protein electrophoresis. Treatment involves chemotherapy, steroids, radiation, and symptom management. Prognosis depends on factors like extent of organ damage and tumor burden, with median survival around 3 years.

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    of 16

    MULTIPLE MYELOMA

    ______________
    Rahmawati Minhajat
    A. Fachruddin Benyamin

    Subdivisi Hematologi & Onkologi Medik


    Bag. Ilmu Penyakit Dalam
    FKUH
    Malignant Plasma Cells in
    Marrow
    * Multiple Myeloma

    _________________________________
    = Mieloma Multipel (MM)

    = Kahlers disease
    = Keganasan sel plasma
    * Pendahuluan

    _________________________________
    MM = keganasan sel plasma

    1. Terjadi perubahan pada SST


    2. Osteolitik & destruksi tulang
    3. Terbtknya para-protein (prot
    abn)
    1. Perubahan SST

    _________________________________
    Jumlah sel plasma sangat
    meningkat
    Supresi mielopoesis secr humoral

    anemia
    keggl SST secr menyeluruh
    2. Destruksi tulang

    _________________________________
    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
    _________________________________
    Sel plasma maligna mensekresi
    suatu
    para-protein = protein M
    (abnormal)
    Umumnya berbtk IgG atau IgA

    sindr.hiperviskositas
    3. Sekresi protein
    abnormal(2)
    _________________________________
    Komponen rantai ringan (light-
    chain)
    dari Ig gagal ginjal
    (kdg2 diperberat oleh
    hiperkalsemia)
    Katabolisme para-protein
    amiloid
    gagal jantung & neuropati
    * Gbr. klinis

    _________________________________
    Peny. lanjut usia (median : 60 th)

    Anemia, LED tinggi


    Nyeri tulang : costa, vertebra

    Fraktur patologik : colum femoris

    Ggl ginjal, kompresi med.spinalis


    * Gbr. Klinis (2)

    _________________________________
    Sindr.hiperviskositas :
    perdrh.mukosa,
    nausea, vertigo, ggn visus, ggn
    jiwa.
    Pucat, nyeri tulang, neuropati

    Ggl jantung kongestif


    * Laboratorium

    _________________________________
    Anemia ( normokrom )

    LED sangat tinggi ( mis. 150 / 160


    )
    Hiperkalsemia ( Ca >> )

    Proteinuria (Bence Jones protein)


    Elektroforesis protein serum
    abnormal
    (spike monoclonal pd beta atau
    Serum Protein
    Electrophoresis
    Normal Monoclonal Protein in Myeloma

    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

    _________________________________
    Median survival : 3 thn

    Px lbh buruk pada : spikes


    paraprotein
    sangat tinggi, ggl ginjal,
    hiperkalsemia
    & ggn tulang yg ekstensif.
    * Prognosis (2)
    High Tumor Burden :
    spike IgG > 7 g/dl
    hematokrit < 25 %
    ca serum > 12 mg/dl
    atau lesi osteolitik > 3 lokasi
    median survival 1 thn.

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