Multiple Myeloma Cancer:
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Multiple myeloma (MM) is a malignant plasma cell carcinoma.
Cancer cells originate from the bone marrow plasma cells and plasma cells are
the cells that develop white blood cells B to the final stage. Therefore, many
types of myeloma can be classified as B lymphocytic lymphoma. Currently
classified by WHO is a type of B-cell lymphoma called plasma cell myeloma /
plasmacytoma. It is characterized by the abnormal proliferation of bone marrow
plasma cells along with the over-production of monoclonal Immunoglobulin or
light chain (M protein), very few patients can MM, MM not recorded, that does
not produce multiple M protein, myeloma, often accompanied by multiple
osteolytic ulcers, hypercalcemia, anemia, and damage. Kidney Since normal
immunoglobulin production is suppressed, various bacterial infections are more
likely to occur. The incidence is approximately 2 to 3 / 100,000, with a
male-female ratio of 1.6: 1 and most patients are older than 40 years.
Clinical symptoms
Many myelomas start slowly and do not have obvious symptoms at
the initial stage, which is easy to misdiagnose. The clinical manifestations of
MM is diverse, mainly including anemia, bone pain, renal failure, infection,
bleeding, neurological symptoms. hypercalcemia, amyloidosis, etc.
1. Bone pain, bone deformation, and pathological fracture
Myeloma cells Secrete Cancer osteoclast and stimulate osteoclast to
dissolve and destroy bones. Bone pain is the most common symptom, most of which
is lumbosacral, sternum and rib pain. Because the destruction of bones by
cancer cells causes pathological fracture and may have multiple fractures at
the same time.
2. Anemia and bleeding
Anemia is more common and is the first symptom. Early anemia
is mild and late anemia is severe. Thrombocytopenia may occur at a high stage,
causing bleeding. Bleeding of the skin and mucous membranes is more common, and
in severe cases, bleeding can occur in internal organs and in the skull.
3. Liver, spleen, lymph nodes and kidney disease
Swelling of the liver and spleen, enlargement of lymph nodes
in the neck, myeloma, and kidneys. An enlarged or abnormal mass that requires
extramedullary plasmacytoma or amyloidosis.
4. nervous system symptoms
extramedullary plasmacytoma Of the nervous system can appear
limb paralysis, sleepiness, coma, diplopia, blindness, and loss of vision.
5. Many bacterial infections are common in many types of
myeloma.
Fungal and viral infections are the most common - bacterial
pneumonia, urinary tract infections, and bacterial herpes zoster infections are
more likely to occur, especially in patients with low immunity after treatment.
6. Impaired renal function
50% to 70% of patients have protein, red blood cells, white
blood cells, liberate, urination, chronic renal failure, hyperlipidemia,
hyperlipidemia, hyperlipidemia, hyperemia
7. High viscosity syndrome
Dizziness, dizziness and visual impairment can occur and
fainting, unconsciousness, and disturbance of consciousness can occur
immediately.
8. Amyloid
Usually occurs in the tongue, skin, heart, gastrointestinal
tract and other parts.
9. Mass or plasma cell tumors
Some patients may have masses from a few centimeters to tens
of centimeters in diameter, which may be a bone mass or a soft tissue mass.
These pathological examinations are mostly plasmacytosis. It is generally
believed that patients with soft tissue mass or plasmacytosis have a poor
prognosis and have short-term survival.
10. The formation of blood clots or muscles
Patients may have hemodialysis fistula infarction, deep vein
thrombosis or myocardial infarction. The cause is associated with factors such
as sensitivity to thrombosis, tumors and high viscosity in tumor patients.
Checking
Normal biochemical examination
The abnormal serum globulin increases while the albumin is
normal or decreased. Urocoagulin (also known as the weekly urine protein) is
half the value.
electrophoresis The patient's proteins or the results of the
M protein identification will appear in a clear "M peak" or "M
protein" manner. Therefore, on a regular biochemical examination, if the
number of globulin increases or "M peak" Abnormal elevations appears
in the protein electrophoresis. You should go to the hematology department,
except for the diagnosis of myeloma.
Blood test
Most anemias are positive cells, good pigment formation,
normal platelets or low platelets.
3. Bone marrow examination
The number of abnormal plasma cells increased is ≥10%, and it
is a primitive or innocent plasma cell that is deformed.
4. Bone X-ray examination
Can see much penetrating osteoporosis like osteoporosis or
osteoporosis, pathological fractures.
For bone damage in patients with MM, CT, nuclear magnetic
resonance (MRI) and others, generally considered to have a better chance of
finding a wound than an X-ray examination; The sensitivity of these X-ray
imaging methods
5. Biological examination, such as chromosome and
fluorescence in source breeding (FISH)
Removal of chromosomes in the bone marrow 17p13 and/or t
(4; 14) and/or t (14; 16) often indicates a high risk. Fluorescence in hybrid
origin (FISH), especially the use of CD138 (positive expression in most myeloma
cells), pure magnetic beads, FISH, iFISH test can improve the positive test
rate This test was used in the newly developed Universal Prognosis System
(R-ISS Preparation System) in 2015.
6. Serum-free light chain inspection
It has