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Multiple myeloma is a cancer of plasma cells that results in overproduction of monoclonal proteins. Plasma cells normally produce antibodies but in multiple myeloma they accumulate abnormally in the bone marrow and interfere with normal blood cell production. Symptoms include fatigue, bone pain, recurrent infection, and kidney problems. Diagnosis involves blood and urine tests showing the monoclonal protein and reduced numbers of red blood cells and platelets. Treatment may include chemotherapy, steroids, radiation, stem cell transplant, pain medications, and managing complications like anemia, hypercalcemia, and bone lesions.
Multiple myeloma is a cancer of plasma cells that results in overproduction of monoclonal proteins. Plasma cells normally produce antibodies but in multiple myeloma they accumulate abnormally in the bone marrow and interfere with normal blood cell production. Symptoms include fatigue, bone pain, recurrent infection, and kidney problems. Diagnosis involves blood and urine tests showing the monoclonal protein and reduced numbers of red blood cells and platelets. Treatment may include chemotherapy, steroids, radiation, stem cell transplant, pain medications, and managing complications like anemia, hypercalcemia, and bone lesions.
Multiple myeloma is a cancer of plasma cells that results in overproduction of monoclonal proteins. Plasma cells normally produce antibodies but in multiple myeloma they accumulate abnormally in the bone marrow and interfere with normal blood cell production. Symptoms include fatigue, bone pain, recurrent infection, and kidney problems. Diagnosis involves blood and urine tests showing the monoclonal protein and reduced numbers of red blood cells and platelets. Treatment may include chemotherapy, steroids, radiation, stem cell transplant, pain medications, and managing complications like anemia, hypercalcemia, and bone lesions.
The special proteins are typically monoclonal paraprotein (M protein) and other compounds such as immunoglobulins.
B lymphocytes start in the bone marrow and move to the lymph nodes. As they progress, they mature and display different proteins on their cell surface. When they are activated to secrete antibodies, they are known as plasma cells. are white blood cells that secrete large volumes of antibodies Plasma cells, also called plasma B cells . Male:Female 2:1 Radiation- exposure to petroleum products Having a family member affected by multiple myeloma
Collections of abnormal plasma cells accumulate in the bone marrow, interfere with the production of normal blood cells
Increased osteoclastic activity and decreased osteoblastic activity through release of cytokines
Symptoms of hypercalcemia Nausea Fatigue Thirst
(hemoglobin <10 g/dL) Usually normocytic and normochromic Can be megaloblastic due to either folate or vitamin B12 deficiency Due to Replacement of normal marrow by expanding tumor cells Inhibition of hematopoiesis by factors made by the tumor Mild hemolysis
ESR (elevated)
given orally for Prednisone 4-7 days and repeated 4-6 week interval
2. Radiation Myeloma is radiosensitive Relieves pain Can be used for control of local disease Total body irradiation not advised 3. Bone marrow transplantation
To reduce serum calcium level Corticosteroid Hydration
Red Blood Cell transfusions or erythropoietin can be used for management of anemia. Surgical options
Compression of intraspinal nerves laminectomy,removal of myelomatous tissue and post-op irradiation In cases with instability - spinal fusion
Supportive therapy Erythropoetin Biphosphonates: (pamidronate) Antibiotics and GM-CSF Anti-virals esp. herpes Assess for bone involvement Assess for hypercalcemia, measure the calcium level frequently Fluids are administered to increase urinary output Caution should be taken while moving or transferring the patient, because there is risk of pathologic fracture
Analgesics should be given to reduce bone pain Braces (especially spinal braces ) may also help to reduce pain Monitor intake and output Administer IV fluids Small frequent diet should be given to reduce nausea Closely monitor the clients mental status Counseling should be given to the patient and family