Bm Transplant And Myeloma - Moskovitz

Front 1

Where does the antigen-independent phase of plasma cell development occur?

Back 1

bone marrow (heavy and light chain rearrangement, surface Ig expression)

Front 2

Where does the antigen-dependent phase of plasma cell development occur?

Back 2

spleen, LN (antigen presentation and somatic hypermutation)

Front 3

All the plasma cell disorders occur during the transition from _____ cells to plasma cells.

Back 3

memory

Front 4

What is MGUS?

Back 4

- low grade clonal proliferation (<10% plasma cells in BM)
- asymptomatic
- can convert to MM (1%)

Front 5

What is plasmacytoma?

Back 5

- isolated plasma cell tumor, or part of MM
- occurs in different sites (in skeletal or soft tissue)
- skeletal involvement more likely progress to MM
- local Tx with radiation

Front 6

What is multiple myeloma?

Back 6

- diffuse plasma cell growth
- end organ damage

Front 7

How does multiple myeloma present?

Back 7

- back pain, osteoporosis
- fatigue, anemia
- high ESR
- proteinuria

Front 8

Criteria for Dx Multiple Myeloma:

Back 8

1) M-spike in serum or urine
2) >10% clonal plasma cells in BM
3) end-organ damage
4) hypercalcemia
5) lytic bone lesions
6) anemia
7) renal insufficiency
* hyperviscosity, amyloidosis

Front 9

How does multiple myeloma cause hypercalcemia?

Back 9

osteoclast activating factors (mostly IL-1)

Front 10

What are the si/sx of hypercalcemia?

Back 10

- ab pain, constipation
- confusion, lethargy
- renal insufficiency (calcium is diuretic)

Front 11

How do you Tx multiple myeloma?

Back 11

1) alkyating agents (melaphalan, prednisone)
2) nonalkylating agents (vincristine, adriamycin, decadron)
3) thalidomide, revlimib