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Flashcards in Myeloma Deck (76)
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1

What kind of cancer is myeloma?

Haematological

2

What is the prevalence of myeloma in the UK?

4 in 1000

3

Is myeloma more common in men or women?

Equal

4

What ethnicity is myeloma more common in?

Afro-Caribbean populations

5

What is the principle risk factor for myeloma?

Age

6

At what age do most cases of myeloma occur?

65 or older

7

At what age is myeloma rare?

Patients under 35

8

What kind of cells does myeloma arise in?

B-cells

9

What is myeloma caused by?

Clonal proliferation of mature plasma cells that secrete immunoglobulins or fragments of

10

In what % of myeloma patients are karyotype abnormalities found?

50%

11

What molecular abnormalities are recognised in myeloma?

- 14q32 translocations
- Chromosome 13 deletions
- FGFR3 activation

12

What is characteristically produced in myeloma?

Paraprotein

13

How is paraprotein product in myeloma?

The clonal population undergo immunoglobulin class switching and somatic hypermutation, leading to the overproduction of a single immunoglobulin class, referred to as paraprotein

14

What happens to the plasma cells once they have mutated in myeloma?

They typically migrate to the bone marrow, causing bone marrow infiltration

15

What produces osteolysis and destructive bone lesions in myeloma?

Dysregulation of the osteoprotegrin rankl system by tumour-secreted cytokines

16

How does myeloma often present?

Significant bone pain

17

What causes the bone pain in myeloma?

Destructive lytic lesions or pathological fractures

18

What other bone pathology is common in myeloma?

Vertebral collapse

19

What might vertebral collapse lead to in myeloma?

Spinal cord compression, which is an emergency

20

Other than bone symptoms, how might myeloma present?

Vague symptoms, including;
- General malaise
- Aches and discomfort
- History of repeated infection

21

What causes the general malaise in myeloma?

Anaemia

22

How is myeloma increasingly diagnosed?

Due to an incidental finding on blood count, with pancytopenia or anaemia

23

What are the important red flags for myeloma?

- Unexplained back pain
- Night sweats
- Weight loss
- Extreme lethargy

24

What complications may be presenting features of myeloma?

Renal impairment and progressive renal failure

25

What causes renal impairment and progressive renal failure in myeloma?

Amyloidosis or deposition of paraprotein in the kidneys

26

Why might patients with myeloma develop atypical infections?

Due to pancytopenia

27

What initial investigations are required in suspected myeloma?

- FBC
- Measurement of ESR
- Serum protein electrophoresis

28

What is the most common finding on FBC in myeloma?

- Normocytic, normochromic anaemia of chronic disease
- Anaemia or pancytopenia due to marrow infiltration

29

What happens to ESR in myeloma?

Raised

30

What is found on urine and plasma electrophoresis for immunoglobulins in myeloma?

A monoclonal paraprotein band