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Definition:
Epidemiology: 3- 4 new cases / 100 000 / year
M> F
50-60 years
Multiple Myeloma: pathogenesis
Hypercalcemia syndrome
Hyperviscosity syndrome
Multiple Myeloma: clinical picture
Marrow failure syndrome
Pain syndrome
Kidney failure
Hypercalcemia syndrome: weakness, confusion and
depression, or an abnormal heart rhythm including
cardiac arrest
Hyperviscosity syndrome: Headache, visual changes
and retinopathy
Multiple Myeloma: laboratory analysis
Blood count
Bone Marrow aspirate
Serum protein electrophoresis
Detection of Bence Jones (light chain) urinary (
nephelometry)
calcemia
serum viscosity
C reactive protein
Skeletal survey
Multiple Myeloma – bone marrow
Bone marrow aspirate: plasma cell infiltration
Serum protein electrophoresis
Kit
SEBI
A
Serum protein electrophoresis
skull
backbone
rib crib
pelvis
long bones (femur, humerus)
MGUS SMM MM
Bone marrow palsma < 10% >10 – 60% > 10% or biopsy proven
cells plasmacytoma
AND OR
M - spike < 3 g/ dl serum or < 500 > 3 g/ dl serum or >
mg / day urine 500 mg / day urine
AND AND AND
Myeloma- defining None None ≥1
event
Chesi M, International Journal of Laboratory Hematology, Volume 37, 108–114, May 2015
Diagnostic criteria for MGUS, SMM and MM
Chesi M, International Journal of Laboratory Hematology, Volume 37, 108–114, May 2015
International Staging System (ISS)
2. Proper diagnosis
I. Treatment complications
Treatment:
- Surgical resection
- Radiotherapy
Monoclonal gammopathy of unknown
significance (MGUS)
Hemorrhagic manifestations
Supportive therapy