Multiple myeloma blood american society of hematology. The anemia, or severe red blood cell deficiency, is largely caused by the multiple myeloma itself, but can also be made worse by certain types of chemotherapy. C calcium, elevated, r renal failure, a anemia, b bone lesions. Multiple myeloma accounts for approximately 10% of hematologic malignancies. Multiple myeloma causes, risk factors, and prevention. There are three major forms of renal damage in patients with multiple myeloma.
The bone marrow produces red blood cells, which carry oxygen throughout. Impaired antibodies and leukopenia cause recurrent infections, usually from encapsulated organisms pneumonia is the most common infection. Evaluation of anaemia in patients with multiple myeloma and lymphoma. Multiple myeloma stages survival rates by stage for multiple myeloma. Common manifestations include lytic lesions in bones causing pain, andor fractures, renal insufficiency, hypercalcemia, anemia, and recurrent infections. Multiple myeloma, the most common bone malignancy, is occurring with increasing frequency in older persons. Several causes have been implicated, but anemia of chronic disease with inadequate erythropoietin epo production related to the inflammatory cytokines appears to be of utmost importance. Multiple myeloma hematology and oncology merck manuals. In multiple myeloma mm, genetic damage occurs in the developing. Multiple myeloma mm is the most frequent cancer to involve the skeleton with 8090% of patients developing bone lesions during their disease course.
Pdf iron deficiency in a male with multiple myeloma researchgate. Hemoglobin value 10 gdl serum calcium value normal or multiple myeloma mm arises from postgerminal b cells in the lymph node, with immunoglobulin ig gene rearrangement, extensive somatic hypermutation, and class switching of immunoglobulin heavy chain igh genes, suggesting that the malignant plasma cells have undergone antigen selection. At least 60%70% of patients with mm have anemia at the time they are diagnosed, and most will experience it during the course of the disease. What is the pathophysiology of multiple myeloma mm.
Multiple myeloma is a type of cancer that affects plasma cells. Multiple myeloma dr harpreet singh bhatia dmch, ludhiana,punjab 2. These abnormal cells, referred to as myeloma cells, disrupt normal bone marrow function and invade the. Multiple myeloma is a cancer of plasma cells that produce monoclonal immunoglobulin and invade and destroy adjacent bone tissue. Multiple myeloma is a cancer that develops in the bone marrow, the spongy tissue found in the center of most bones. Jun 25, 20 classification stage i low cell mass 600 billion myelomacellsall of the following. People with multiple myeloma experience fatigue due to the low red blood cell count caused by the cancer. Ludwig h, fritz e, kotzmann h, hocker p, gisslinger h, barnas u. As it progresses, bone pain, bleeding, frequent infections, and anemia may. First described in 1848, mm is characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein m protein. Pathophysiological underpinnings of multiple myeloma. Jan 11, 2016 myeloma classification monoclonal gammopathy of undetermined significance serum mprotein 3 gdl andor bone marrow plasma cells. Viscometric studies were made by comparing the patients whole blood, plasma and washed red blood cells with. If there are too many myeloma cells in the bone marrow, some of these blood cell levels can be low.
The most frequent underlying pathophysiological mechanism is anemia of. Bone marrow infiltration by multiple myeloma causes anemia by. The implications of anemia in multiple myeloma moshe mittelman multiple myeloma mm is commonly associated with anemia. Multiple myeloma may be diagnosed sooner in those people than those.
Anemia hemoglobin feb 27, 2019 please use one of the following formats to cite this article in your essay, paper or report. Multiple myeloma is the second most common type of blood cancer after leukemia. For some types of cancer, risk factors are known for the majority of cases. Multiple myeloma mm infiltrates bone marrow and causes anemia by disrupting erythropoiesis, but the. Multiple myeloma is a clonal plasma cell malignancy that accounts for slightly more than 10% of all hematologic cancers. Jun 22, 2010 the anemia, or severe red blood cell deficiency, is largely caused by the multiple myeloma itself, but can also be made worse by certain types of chemotherapy. Weakness and malaise are usually associated with anemia in multiple myeloma.
Multiple myeloma mm is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance mgus to plasma cell leukemia. Myeloma is a cancer of the plasma cells in the bone marrow. If your physician suspects you have anemia, your blood will be drawn for lab tests. Anemia is the term used to describe a low count of these cells. The implications of anemia in multiple myeloma sciencedirect. This activity is accompanied by suppressed osteoblast differentiation and activity, resulting in severely impaired bone formation and development of devastating osteolytic lesions. Managing anemia in lymphoma and multiple myeloma article pdf available in therapeutics and clinical risk management 42. Multiple myeloma mm, also known as plasma cell myeloma and simple myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Multiple myeloma mm, also known as plasma cell myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Multiple myeloma anemia international myeloma foundation. Multiple myeloma mm is a plasma cell dyscrasia characterized by terminally differentiated plasma cells, infiltration of the bone marrow by plasma cells, and the presence of a monoclonal immunoglobulin or immunoglobulin fragment in the serum andor urine. Monitor for multiple myeloma symptoms and m protein serum and urine every six to 12 months. Anemia is often the first symptom of multiple myeloma.
Blood chemistry tests levels of blood creatinine, albumin, calcium, and other electrolytes will be checked. Jun 12, 2019 multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Signs and symptoms of multiple myeloma tests to find multiple myeloma stages and outlook prognosis after a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. Multiple myeloma is a cancer of the plasma cells in the bone marrow seek medical care for unexplained pain, nausea, vomiting, weight loss, vision problems, or chronic tingling or numbness there is no cure. The bone marrow produces red blood cells, which carry oxygen throughout the body. When patients with myeloma have disease outside the bone marrow, this is called extramedullary disease emd. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Symptoms and signs include anemia, skin lesions, weakness, and bone fractures. The most frequent underlying pathophysiological mechanism is anemia of chronic disease acd, relative erythropoietin epo deficiency due partly to renal impairment and myelosuppressive effects of chemotherapy, but many. Learn more about the symptoms, causes, diagnosis, risk factors, and treatment of multiple myeloma. Multiple myeloma symptoms, diagnosis and treatment bmj. Multiple myeloma mm is a plasma cell malignancy in which monoclonal plasma cells proliferate in bone marrow, resulting in an overabundance of monoclonal paraprotein m protein, destruction of bone, and displacement of other hematopoietic cell lines. Multiple myeloma mm is a cancer of plasma cells in the bone marrow. Multiple myeloma epidemiology and patient geographic distribution in canada.
Production of monoclonal protein by myeloma cells the characteristic property of myeloma cells is the production and secretion release of monoclonal protein into the blood andor urine. Normally, plasma cells produce antibodies and play a key role in immune function. Multiple myeloma symptoms side effects complications. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Multiple myeloma mm is a malignant plasma cell disorder that accounts for approximately 10% of all hematologic cancers. Pdf managing anemia in lymphoma and multiple myeloma. The etiology and pathogenesis of anemia in multiple myeloma anemia occurring in patients with mm is multifactorial. Blood is a vital liquid that lows through your veins and arteries. A systematic analysis for the global burden of disease study 2016. Malignant plasma cells can supplant normal plasma cells in the bone marrow bm. With multiple myeloma, few cases are linked to risk factors that can be avoided, so there is no known way to prevent most multiple myelomas from developing. Multiple myeloma is cancer that starts in the bone marrows plasma cells.
Abnormal antibody fragments are produced in multiple myeloma and are deposited in various organs, such as the kidneys. Anaemia in multiple myeloma is usually normochromic and normocytic. Evaluation of anaemia in patients with multiple myeloma and. As it progresses, bone pain, bleeding, frequent infections, and anemia may occur. A mnemonic sometimes used for the common mm pathologies is crab. Patients may present with nonspecific symptoms, such as nausea, vom iting, malaise, weakness, recurrent infections, or weight loss. Scribd is the worlds largest social reading and publishing site. Patients endure severe bone pain, pathologic fractures, hypercalcemia, and a markedly decreased quality of life. The etiology and pathogenesis of anemia in multiple myeloma. Epidemiology and pathophysiology multiple myeloma accounts for 1.
Bone marrow invasion leads to anemia, and immunologic alterations contribute to recurrent infections. Described here is a case of multiple myeloma in a patient with sickle cell anemia. Malignanat b cell lymphoproliferative disorder of the marrow with plasma. The multiple myeloma induced bone destruction is a result of the increased activity of osteoclasts that occurs adjacent to multiple myeloma cells. Pathophysiology and diagnosis of multiple myeloma jatin shah, md, explains that there is no clear reason for why patients develop multiple myeloma, and so theres no clear risk factor. Read about multiple myeloma prognosis, life expectancy, stages, treatment, diagnosis, and causes. Anemia healthy changes national heart, lung, and blood. In asymptomatic patients, multiple myeloma is most likely to be identified through laboratory abnormalities such as hypercalcemia, anemia, or proteinuria. Pathophysiology immunoglobulin ig molecules contain two linked. Anorexia, nausea, somnolence, and polydipsia are common symptoms due to hypercalcemia. Common manifestations include lytic lesions in bones causing pain. Multiple myeloma early detection, diagnosis, and staging. We hope that the information will be helpful to both healthcare professionals and patients. Pdf immunoglobulin a myeloma in a newly diagnosed sickle.
Myeloma bone disease is responsible for some of the most devastating complications of the disease. A number of supportive therapies including medications called red blood cell growth factors or supplementation with iron, folate, or vitamin b 12 may be used to treat anemia in. Minimal residual disease in multiple myeloma multiple myeloma pathophysiology and epidemiology multiple myeloma mm is a plasma cell malignancy in which abnormal, clonal plasma cells proliferate and accumulate within the bone marrow. However, uncontrolled growth of these cells leads to bone pain and fractures, anemia, infections, and other complications. Erythropoietin treatment of anemia associated with multiple myeloma. The most common finding is a low red blood cell count anemia2. Hemoglobin value 10 gdl serum calcium value normal or oct 09, 2017 people with multiple myeloma experience fatigue due to the low red blood cell count caused by the cancer. Plasma cells are a type of white blood cell found in bone marrow, which is the soft tissue inside most of your bones that produces. Multiple myeloma mm is a plasma cell dyscrasia characterized by terminally differentiated plasma cells, infiltration of the bone marrow by plasma cells, and the presence of a monoclonal immunoglobulin or. Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Over 60% of multiple myeloma patients have anemia at the time they are diagnosed, and most remaining patients become anemic during the course of their disease. Anemia is a common complication in patients with multiple myeloma mm and occurs in more than two thirds of all patients.