Multiple Myeloma Exam With Verified Solutions Graded A+

Multiple Myeloma Exam With Verified Solutions What is Multiple Myeloma? This is a bone marrow (B cell) cancer characterized by the proliferation of malignant plasma cells that can aggregate into tumor masses and then become distributed throughout the skeletal and organ systems resulting in multiple organ damage. What is a Plasma Cell? Immune cell that develops from a B-cell Secretes Antibodies malignant plasma cell Malignant plasma cells from one clone of B cells abnormally large amounts of 1 type of immunoglobulin (usually IgG, occasionally IgA or IgM) What are Immunoglobulins? Antibody (Ab) proteins produced by plasma cells as part of the immune system. Binds to foreign antigens Released by activated B cells IG Stucture: 4 protein chains - two longer ones ("heavy chains") & two shorter ones ("light chains") connected by disulfide bonds into a Y-shaped structure. Myeloma Pathogenesis May involve chromosomal translocations (or break points), oncogene mutation, inactivation of tumor suppressor genes. To some degree still don't understand how this happened or what caused the mutations or translocations what happens after chromosomal trans location Marrow to blood stream, circulating to lymph nodes, develop more, then return to soft tissue or marrow. Soft tissue sites to form plasmacytoma Can do damage in the bones Ineffective antibody production leads to Damage to bone, kidneys from antibodies, plasmacytomas epidemiology Median Age at Dx = 70yo Incidence: ALL RACES, ALL GEOGRAPHY Currently incurable** 2nd most prevalent blood cancer (after NHL) Presentation Renal failure Spinal cord compression (plasmacytoma- bowel and bladder dysfunction) Fatigue (due to anemia?) Bone Pain (damage in the skeleton) Pathologic fracture (eaten out appearance) Incidental finding Normocytic anemia