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Path - Plasma cell neoplasms + related disorders (iii) 1) Multiple Myeloma
Path - Plasma cell neoplasms + related disorders (iii) 1) Multiple Myeloma
More clinical features
increased bleeding
2 reasons why
thrombocytopenia
Igs interfere with normal coag
recurrent infection
! sepsis
most common cause of death
1 type of Ig not sufficient (others are diminished)
esp with encapsulated bacteria (staph, strep, E coli)
also due to leukopenia
amyloidosis
in kidneys: nephrotic syndrome
in heart: restrictive cardiomyopathy
tongue: enlargement
Dx
rectal Bx
Congo red stain + polarised light
apple green birefringence
no Tx
Prognosis
untreated - death in 6-12 months
median survival = 4-7 yrs
Tx
no curable
new
immunomodulatory
inhibit CKs, IL6, angiogenesis
proteasome inhibitors
if tumour cell can't recycle proteins the accumulation results in cell death
bisphosphonates for hypercalcaemia
autologous/allogeneic BM transplant