multiple myeloma

by: HASPREET KAUR GILL

MULTIPLE MYELOMA:
• Malignanat B cell lymphoproliferative disorder of
the marrow with plasma cell predominating.
• Most common primary malignancy of bone.
• rarely effect < 40 years old, common in elderly
• male: female is 2:1
• Plasma cells come from B lymphocytes, and
produce antibodies (immunoglobulins).
. – Overproduce monoclonal protein or paraprotein.
– Ineffective immunoglobulins.
– Leads to decreased bone marrow function.
– Destruction of bone tissue.
Bone marrow aspirate demonstrating plasma cells
of multiple myeloma. Note the blue cytoplasm,
eccentric nucleus, and perinuclear pale zone (or
halo).
basics of plasma cell
risk factors:
• Age >60.
• Exposure to pesticides ( DDT ).
• Radiation
• Wood,leather,sheet metal & nuclear industry worker
• Exposure to ptroleum products (Benzene)
• Kaposi’s sarcoma Herpes Virus(Presence of IL- 6 and HHV8 )
pathophysiology

BY: HASPREET
by : Haspreet
 INVESTIGATION:
• FBC- HB low due to anemia
• ESR, CRP-almost always raised.
• Blood film- Rouleaux formation, macrocytosis.
• U&Es, Creatinine high-renal failure
• Serum B2 microglobulin >2.5mg/L.
• Raised LDH
• Serum calcium- raised.
• Serum albumin- normal or low.
• SPE- monoclonal band.
• Uric acid-normal or raised
• 24-hour urine electrophoresis (benes jones protein found)
-immunofixation is used for assessment of light-chain
excretion.
• Bone marrow aspirate or trephine shows characteristic
infiltration by plasma cells .
diagnosis
management:
1. radiotheraphy
2. chemotheraphy