Myeloma Disease (Multiple Myeloma)

Myeloma (multiple myeloma)

Myeloma (multiple myeloma) is an intracellular tumor characterized by pathological proliferation of plasma cells at the final stage of differentiation. It accounts for 10% of all hematological tumors, the annual incidence is 35 per 100,000 people.

Pathogenesis
Ionizing radiation increases the incidence of disease. Immunoglobulins are produced by plasma cells after antigenic stimulation. Monoclonal immunoglobulins have an identical light chain type and epitope. It is believed that a pluripotent stem cell undergoes tumor transformation.

Typical chromosomal disorders: monosomy of chromosome 13, trisomy of chromosomes 3, 5, 7, 9, 11, 15 and 19. The cytokines IL-5 and IL-6 are significant in the pathogenesis. From tumor transformation of the progenitor cell to clinical manifestations, there is a preclinical stage of ~20-30 years.

Clinical manifestations
Caused by proliferation and secretion of monoclonal immunoglobulin. In 99% of cases, M-protein is detected in serum or urine.

Characterized by damage to flat bones with pain and pathological fractures. Possible compression of the spinal cord. There is anemia, other cytopenias, decreased levels of immunoglobulins, and increased susceptibility to infections.

The kidneys are often affected. There may be coagulation disorders, hyperviscose syndrome, amyloidosis.

Diagnostics
Blood and urine tests, bone marrow puncture, determination of M-protein, x-ray of skeletal bones.

Treatment
Melphalan + prednisolone, polychemotherapy, interferons, stem cell transplantation, radiation therapy. If organs are compressed, surgical intervention is required.