Multiple Myeloma Exam With Verified
Solutions Latest
What is multiple myeloma (MM)?
A malignant proliferation of terminally differentiated B lymphocytes (plasma cells) resulting in end-
organ damage
What is the incidence of MM?
1% of all cancers and 10% of all hematologic malignancies
What is the median age for the development of MM?
The median age is 65 years.
What are the risk factors for the development of MM?
The disease is much more common in African Americans. Exposures to radiation, alkylating agents,
asbestos, pesticides, HHV-8, and SV40 have been implicated as risk factors.
Do all patients with MM have an M protein in the serum?
No. Only 80% of patients have an M protein in the serum; 20% have only light chains, which can be
measured in a 24-hour urine collection or with a serum light-chain assay. These light chains will NOT
be picked up on a regular urinalysis. Approximately 1% of patients with MM are termed
"nonsecretors" and have no identifiable M protein.
In nonsecretors, where is the immunoglobulin?
On staining of the plasma cells, the protein is shown to be within the cytoplasm, but the plasma cells
cannot excrete the immunoglobulin molecule.
What are the clinical manifestations of MM?
Osteolytic bone lesions with an associated risk of pathologic fractures of the long bones, vertebrae,
pelvis, and ribs
Anemia and pancytopenia
Hypercalcemia
Renal insufficiency
Recurrent bacterial and viral infections (due to
hypogammaglobulinemia)
Hyperviscosity
Peripheral neuropathies
Spinal cord compression (not common) Myelomatous meningitis (not common)
What are the causes of renal insufficiency or failure in patients with MM?
Amyloidosis, light-chain deposition disease, hypercalcemia, hyperuricemia with uric acid
crystallization within the collecting ducts and tubules, and plasma cell infiltration
What are the major criteria for the diagnosis of MM?
- M protein > 3.5 g/dL (IgG) or >2 g/dL
- (IgA) Marrow plasmacytosis > 30%
- Plasmacytoma
Solutions Latest
What is multiple myeloma (MM)?
A malignant proliferation of terminally differentiated B lymphocytes (plasma cells) resulting in end-
organ damage
What is the incidence of MM?
1% of all cancers and 10% of all hematologic malignancies
What is the median age for the development of MM?
The median age is 65 years.
What are the risk factors for the development of MM?
The disease is much more common in African Americans. Exposures to radiation, alkylating agents,
asbestos, pesticides, HHV-8, and SV40 have been implicated as risk factors.
Do all patients with MM have an M protein in the serum?
No. Only 80% of patients have an M protein in the serum; 20% have only light chains, which can be
measured in a 24-hour urine collection or with a serum light-chain assay. These light chains will NOT
be picked up on a regular urinalysis. Approximately 1% of patients with MM are termed
"nonsecretors" and have no identifiable M protein.
In nonsecretors, where is the immunoglobulin?
On staining of the plasma cells, the protein is shown to be within the cytoplasm, but the plasma cells
cannot excrete the immunoglobulin molecule.
What are the clinical manifestations of MM?
Osteolytic bone lesions with an associated risk of pathologic fractures of the long bones, vertebrae,
pelvis, and ribs
Anemia and pancytopenia
Hypercalcemia
Renal insufficiency
Recurrent bacterial and viral infections (due to
hypogammaglobulinemia)
Hyperviscosity
Peripheral neuropathies
Spinal cord compression (not common) Myelomatous meningitis (not common)
What are the causes of renal insufficiency or failure in patients with MM?
Amyloidosis, light-chain deposition disease, hypercalcemia, hyperuricemia with uric acid
crystallization within the collecting ducts and tubules, and plasma cell infiltration
What are the major criteria for the diagnosis of MM?
- M protein > 3.5 g/dL (IgG) or >2 g/dL
- (IgA) Marrow plasmacytosis > 30%
- Plasmacytoma
