Multiple Myeloma Cancer

Multiple Myeloma Cancer:

This list is provided by the popular medical science project the platform of the National Health and Medical Commission / Medical Encyclopedia Network.

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