Flashcards in Myeloma Deck (76)
What kind of cancer is myeloma?
What is the prevalence of myeloma in the UK?
4 in 1000
Is myeloma more common in men or women?
What ethnicity is myeloma more common in?
What is the principle risk factor for myeloma?
At what age do most cases of myeloma occur?
65 or older
At what age is myeloma rare?
Patients under 35
What kind of cells does myeloma arise in?
What is myeloma caused by?
Clonal proliferation of mature plasma cells that secrete immunoglobulins or fragments of
In what % of myeloma patients are karyotype abnormalities found?
What molecular abnormalities are recognised in myeloma?
- 14q32 translocations
- Chromosome 13 deletions
- FGFR3 activation
What is characteristically produced in myeloma?
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
What happens to the plasma cells once they have mutated in myeloma?
They typically migrate to the bone marrow, causing bone marrow infiltration
What produces osteolysis and destructive bone lesions in myeloma?
Dysregulation of the osteoprotegrin rankl system by tumour-secreted cytokines
How does myeloma often present?
Significant bone pain
What causes the bone pain in myeloma?
Destructive lytic lesions or pathological fractures
What other bone pathology is common in myeloma?
What might vertebral collapse lead to in myeloma?
Spinal cord compression, which is an emergency
Other than bone symptoms, how might myeloma present?
Vague symptoms, including;
- General malaise
- Aches and discomfort
- History of repeated infection
What causes the general malaise in myeloma?
How is myeloma increasingly diagnosed?
Due to an incidental finding on blood count, with pancytopenia or anaemia
What are the important red flags for myeloma?
- Unexplained back pain
- Night sweats
- Weight loss
- Extreme lethargy
What complications may be presenting features of myeloma?
Renal impairment and progressive renal failure
What causes renal impairment and progressive renal failure in myeloma?
Amyloidosis or deposition of paraprotein in the kidneys
Why might patients with myeloma develop atypical infections?
Due to pancytopenia
What initial investigations are required in suspected myeloma?
- Measurement of ESR
- Serum protein electrophoresis
What is the most common finding on FBC in myeloma?
- Normocytic, normochromic anaemia of chronic disease
- Anaemia or pancytopenia due to marrow infiltration
What happens to ESR in myeloma?