Tuesday, 26 July 2011

Multiple myeloma

It is a lymphoproliferative disorder associated with monoclonal gammopathy that can present as abnormal bone fractures,renal failure,blood disorders,hypercalcemia etc.
One of the characteristic feature is Bence Jones proteins.
Diagnosis is established by a bone marrow examination which will show presence of plasma cells >30%in the marrow.
Diagnostic criteria:
  • Clone bone marrow plasma cells >10%
  • Presence of serum/urine monoclonal protein
  • Evidence of end organ damage like hypercalcemia (Sr calcium >11.5mg/dl),Renal insufficiency(Sr creatinine >1.73mmol/L),Anemia (Hb <10g/dl),Bone lesions
Treatment:
    The main stay of treatment includes Corticosteroids in combination with Chemotheraphy (thalidomide,bortezomib,melphalan)

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