Chapter 21in
haematology (multiple myeloma and related disorder)summary
-The term paraprotienaemia refers to the
presnce of a monoclonal immunoglobulin band in serum and reflects the synthesis
of immunoglobin from asingle clone of plasma cells.
-Multiple myeloma is a tumour of plasma cekks that accumulate in the bone marrow, release
a prarprotein and cause tissue damage. The disease has apeak incidence in the
seventh decade .
-Almost all cases of myeloma develop from a pre-existing mnonclonal gammopathy of undetermined
sigificance (MGUS)in which there is low level paraprotien and no 1% of cases
progress to myeloma each year.
-A useful reminder for the spectrum of tissue damage in myeloma is CRAB-
hypercalaemia,renal impairment,anaemia,bone disease.
-in patient younger than 75
years myeloma is usually treated bu intensve chemotherapy
followed by anautologous stem cell transplant using stem cells harvested from
the patient.
-In older patiet chemotherapy alone
is used. However in both age group the disease is virually never cured.now
drugs such as thalidomide,brotezomib are improving the outlook for patients and
avarage survival is now 4-5 years.
- Aplasmacytoma is a localized mass of ,alignant plasma cells and usually treated with
radiotherapy, many cases progress to myeloma.
From
book: Essentail Haematology A.V.HOFFBRAND,P.A.H.MOSS.6EDITION
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