MULTIPLE MYELOMA – A PLASMA CELL MYELOMA or MYELOMATOSIS



History of Multiple Myeloma

Multiple Myeloma is a cancer of plasma cells which are present in blood, has been present since centuries. The first documented case of this disease was issued less than 160 year from today’s date. The first patient of this disease Thomas Alexander McBean excreted a certain type of protein, which was studied by Henry Bence Jones. These proteins were further named as "Bence Jones Proteins". The first diagnosis of multiple myeloma was viable when ROENTGEN’S rays were discovered.

What are the other names of Multiple Myeloma   ?

PLASMA CELL MYELOMA   , MYELOMATOSIS, KAHLER’S DISEASE, MYELOMA

Cause

The cause of Multiple Myeloma is unknown. Several efforts are going on by scientists all around the globe to know the main cause of multiple myeloma.

Risk Factors

 Monoclonal Gammopathy increases the risk of person developing myeloma; obesity is also one of the risk factor in developing myeloma.

Diagnosis

Several diagnostic methods are present for assessment of multiple myeloma. Blood tests, bone marrow biopsy, immunohistochemistry, X-rays, magnetic resonance imaging (MRI), computed tomography (CT-scan) help in the assessment or diagnosis of multiple myeloma.

BLOOD TEST:  Protein electrophoresis of blood & urine is determined. If there is presence of paraprotein (M protein) in the Ƴ-globulin (gamma) region then, it is a case of multiple myeloma. Bence Jones proteins are type of paraprotein

BONE MARROW BIOPSY:  Is generally performed to find out the portion of bone marrow occupied by plasma cells

IMMUNOHISTOCHEMISTRY: Detects plasma cells which secrete immunoglobulins in cytoplasm & sometimes on the surface of the cell. Myeloma cells are often CD56, CD38, CD138 positive & CD19, CD20, CD45 negative

MEDICAL IMAGING: Medical imaging consists of x-rays, MRI scans & CT-scans. In myeloma skeletal survey shows the punched out lesions on the bones. X-ray of skull appears like pepper-pot skull, CT-scans are usually used for imaging the vertebral column

Signs & Symptoms

As plasma cells are present in every part of body along with blood, their disease lead to numerous signs & symptoms which varies to great extent. 

ANEMIA: Due to replacement of normal bone marrow tissue with cancerous cell, the erythropoietic ability of bone marrow is loss, which leads the anemia

BONE PAIN: Bone pain is the major sign in case of multiple myeloma. This is because, the calcium metabolism is affected, due to which there are punched out lesions on the bones. Fracture, compression of spinal cord, kyphosis can occur

IMPAIRED KIDNEY FUNCTION: As there is excretion of proteins in multiple myeloma (M proteins) which are of different sizes & have distinct functions, affects the functioning of kidney in different ways. Increased protein concentration in blood leads to increase workload on kidney

INFECTION: Pneumonia & Pyelonephritis are the common infections occurring

MOUTH: Periodontitis, Gingivitis, swelling, numbness, pain occur in mouth initially

Prevention

Up keeping of normal body weight.

Treatment

Treatment is only done when you are symptomatic.

CHEMOTHERAPY: Treatment is done by cytotoxic anti-neoplasmic drugs, including anti-metabolites & alkylating agents

STEM CELL TRANSPLANT: Also known as bone marrow transplant. Procedure in which patient receives healthy stem cells which are capable of forming blood cells. Patient receives stem cells through a catheter placed into a blood vessel of chest region

Although there are several methods which can be discussed, but these were the important ones.

Epidemiology

In the year 2015, multiple myeloma affected 488,000 people & resulted in 101,000 deaths. Multiple myeloma represents around 2.1% of all cancer deaths in USA. In India nearly 50,000 new cases arise every year. Incidence of multiple myeloma varies from 1.2 to 1.8 per 100,000 in India. Usually men are more prone to myeloma in USA. In UK it is the 16th most common cause of cancer deaths.

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