![]() ![]() The resultant bone lesions are lytic (cause breakdown) in nature, and are best seen in plain radiographs, which may show "punched-out" resorptive lesions (including the "raindrop" appearance of the skull on radiography). RANKL activates osteoclasts, which resorb bone. Myeloma bone disease is due to the overexpression of receptor activator for nuclear factor κ B ligand ( RANKL) by bone marrow stroma. Involvement of the vertebrae may lead to spinal cord compression or kyphosis. Persistent, localized pain may indicate a pathological bone fracture. : 653 Myeloma bone pain usually involves the spine and ribs, and worsens with activity. Bone pain Illustration showing the most common site of bone lesions in vertebraeīone pain affects almost 70% of people with multiple myeloma and is one of the most common symptoms. Each of these three events may occur before any of the CRAB criteria appears, thereby making more people eligible for treatment with myeloma drugs earlier. The so-called IMWG (International Myeloma Working Group) criteria added three myeloma defining events, any one of which indicates presence of active multiple myeloma. Updated, expanded diagnostic criteria are now employed. Bone lesions: osteolytic lesions on skeletal radiography, CT, or PET/CT.Anemia: hemoglobin value of >2g/dL below the lowest limit of normal, or a hemoglobin value Renal insufficiency: creatinine clearance 1.77 mol/L (>2 mg/dL).Calcium: serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL).The CRAB criteria were formerly the benchmark used to establish presence of active multiple myeloma (as opposed to an earlier, generally asymptomatic, "smoldering" form of the disease). Fatigue and bone pain are the most common symptoms at presentation. īecause many organs can be affected by myeloma, the symptoms and signs vary greatly. The word myeloma is from the Greek myelo- meaning "marrow" and -oma meaning "tumor". The disease usually occurs around the age of 60 and is more common in men than women. People newly diagnosed with the disease now have a better outlook, due to improved treatments. Based on data concerning people diagnosed with the disease between 20, about 60% lived five years or more post-diagnosis, with about 34% living ten years or more. It is difficult to judge mortality statistics because treatments for the disease are advancing rapidly. In 2020, there were an estimated 170,405 people living with myeloma in the U.S. In the U.S., forecasts suggest about 35,000 people will be diagnosed with the disease in 2023, and about 12,000 people will die from the disease that year. Globally, about 175,000 people were diagnosed with the disease in 2020, while about 117,000 people died from the disease that year. Bisphosphonates and radiation therapy are sometimes used to reduce pain from bone lesions. Remissions may be brought about with steroids, chemotherapy, targeted therapy, and stem cell transplant. Multiple myeloma is considered treatable, but generally incurable. Another common finding is high blood calcium levels. Multiple myeloma is diagnosed based on blood or urine tests finding abnormal antibody proteins - (often using electrophoretic techniques revealing the presence of a monoclonal spike in the results - termed an m-spike), bone marrow biopsy finding cancerous plasma cells, and medical imaging finding bone lesions. When one tumor is present, it is called a plasmacytoma more than one is called multiple myeloma. The plasma cells can also form a mass in the bone marrow or soft tissue. The abnormal plasma cells produce abnormal antibodies, which can cause kidney problems and overly thick blood. Multiple myeloma may develop from monoclonal gammopathy of undetermined significance (MGUS) that progresses to smoldering myeloma. This is due to the occupational exposure to aromatic hydrocarbon solvents having a role in causation of multiple myeloma. There is an increased risk of multiple myeloma in certain occupations. Risk factors include obesity, radiation exposure, family history, age and certain chemicals. The cause of multiple myeloma is unknown. As it progresses, bone pain, anemia, kidney dysfunction, and infections may occur. Often, no symptoms are noticed initially. Multiple myeloma ( MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Steroids, chemotherapy, thalidomide, stem cell transplant, bisphosphonates, radiation therapy įive-year survival rate 54% / life expectancy 6 years (USA) Plasma cell myeloma, myelomatosis, Kahler's disease, myeloma Īn artist's 3D depiction of myeloma cells producing monoclonal proteins of varying typesĪmyloidosis, kidney problems, bone fractures, hyperviscosity syndrome, infections, anemia : 653īlood or urine tests, bone marrow biopsy, medical imaging ![]()
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