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11 Cards in this Set

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Where does the antigen-independent phase of plasma cell development occur?
bone marrow (heavy and light chain rearrangement, surface Ig expression)
Where does the antigen-dependent phase of plasma cell development occur?
spleen, LN (antigen presentation and somatic hypermutation)
All the plasma cell disorders occur during the transition from _____ cells to plasma cells.
memory
What is MGUS?
- low grade clonal proliferation (<10% plasma cells in BM)
- asymptomatic
- can convert to MM (1%)
What is plasmacytoma?
- 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
What is multiple myeloma?
- diffuse plasma cell growth
- end organ damage
How does multiple myeloma present?
- back pain, osteoporosis
- fatigue, anemia
- high ESR
- proteinuria
Criteria for Dx Multiple Myeloma:
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
How does multiple myeloma cause hypercalcemia?
osteoclast activating factors (mostly IL-1)
What are the si/sx of hypercalcemia?
- ab pain, constipation
- confusion, lethargy
- renal insufficiency (calcium is diuretic)
How do you Tx multiple myeloma?
1) alkyating agents (melaphalan, prednisone)
2) nonalkylating agents (vincristine, adriamycin, decadron)
3) thalidomide, revlimib