multiple MYELOMA

it's a malignant blood disorder involving the plasma cell derived from B cells that produce immunoglobulin (G,A,E,D,M)..usually many different plasma cells will produce different Ig, but in myeloma, single clone of plasma cell is producing identical Ig seen as monoclonal band or paraprotein, on serum or urine..but most of the Ig will deposit at bone marrow and stimulate cytokines release to induce osteoclast activity (bone turnover), therefore patient can complaint of bone pain or easily fracture as well as symptoms of hypercalcemia..

the bone marrow may be suppressed by the deposits and patient may presented with anemia or pancytopenia (reduction in all types of blood cell, RBCs, white cells as well as platelets)..other than that deposition of the paraprotein at kidney may lead to kindey impairment..

plus the defect immunoglobulin may not able to protect our body as the normal one from infection and patient may develop recurrent bacterial infection.

so to diagnose, 2 out of these 3 criterias must be fulfilled

1- increase malignant plasma cell in bone marrow (detection through bone marrow aspiration)

2- serum and/or urine paraprotein (detection through serm & urine electrophoresis)

3- skeletal lesion (detection through X-rays)

and other investigation will be ordered base on presentation..the usual treatment is chemotherapy..but the supportive therapy is aimed for acute management in order to prevent further kidney damage, further deterioration of the bones as well as pain management..

usually the patient die due to renal impairment or infection

median survival rate : 3-4 years as stated in the book..but honestly only God knows..doctors are human, we never know how successful or failure the treatment is..but our job is to do the best for the patient and to suggest them the most beneficial treatment based on study (evidence based medicine)