Plasma Cell Cancer – Flashcards
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Multiple Myeloma is cancer of
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plasma cells
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plasma cells in MM make
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Ig (usually G); Bence Jones proteins, osteoclast stimulating factor
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Path of MM
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plasma cells make incomplete immunoglobulins that don't function properly
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MM presentation
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recurrent infections, AKI, lytic bone lesions pt usually >70 and has CRAB findings
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Dx of MM
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Spep, Upep, skeletal survey ALL POSITIVE
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Confirm Dx of MM with
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Bone marrow bx showing >10% plasma cells
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Tx of MM
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>70 or no donor: chemo (melphagram, steroids, maybe thalidomide and bortesamide) >70 and donor: HSCT
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MGUS path and pt presentation
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path: early myeloma pt: >85 and no CRAB findings
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Dx of MGUS
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Spep + Upep - Skeletal Survey - BMBx <10% plasma cells
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Tx of MGUS
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old pts with no sxs=observe converts to MM at rate of 2%/year
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Waldronstons path and pt presentation
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Path: IgM (forms pentamers) Pt: hyperviscosity syndrome with constitutional symptoms
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Dx of Waldronstoms
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Spep + Upep - SS - BMBx: > 10% lymphocytes
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Tx of Waldronstoms
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Rituximab for chemo and plasmapharesis for hyper viscosity syndrome
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If pt has asx elevated protein gap order
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spep, upep, ss
