What is multiple myeloma?
Neoplastic proliferation of bone marrow plasma cells, characterized by lytic bone lesions, plasma cell accumulation in bone marrow and presence of monoclonal protein in serum and urine
What is the age range of individuals affected by multiple myeloma?
98% >40 years of age, peak in 7th decade
What is the characteristic of malignant plasma cells in multiple myeloma?
Malignant plasma cells have clonally rearranged Ig genes that secrete the same paraprotein that is present in serum
What is the role of cytokines in the development of multiple myeloma?
Aetiology – unknown but cytokines have an important role. Il-6 potent growth factor for myeloma possibly by an autocrine mechanism
What is the main factor responsible for osteolytic lesions in multiple myeloma?
Osteolytic lesions in this disease are probably the result of osteoclast activating factor mainly TNF & IL-1 secreted by myeloma cells
What are the frequent chromosomal alterations seen in multiple myeloma?
Gains, losses & structural alterations to different chromosomes are frequent with clonal evolutions
What is the most frequent monosomy in multiple myeloma and what is its prognosis?
Most frequent monosomy is chromosome 13 – poor prognosis
What are the clinical features of multiple myeloma?
Bone pain, features of anaemia, recurrent infections, features of renal failure &/or hypercalcemia, abnormal bleeding tendency, macroglossia, carpal tunnel syndrome, diarrhea, hyperviscosity syndrome
What are the diagnostic criteria for multiple myeloma?
Bone marrow aspirate or biopsy showing at least 10% of plasma cells or the presence of a plasma cell tumor (plasmacytoma) plus at least one of the following two features, CRAB criteria or detection of specific abnormalities
What are the treatment options for multiple myeloma?
Specific treatments include chemotherapy, stem cell transplantation, IFN-α, radiotherapy, and thalidomide. Supportive treatments include managing symptoms such as renal failure, bone disease, hypercalcemia, compression paraplegia, anemia, bleeding, and infections