Multiple myeloma - Revision history

Aidan at 17:09, 27 September 2024

2024-09-27T17:09:33Z

← Older revision		Revision as of 17:09, 27 September 2024
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	=== Antimicrobial Prophylaxis ===		=== Antimicrobial Prophylaxis ===

			* [[Levofloxacin]] 500 mg p.o. daily for the first 12 weeks after starting chemotherapy may reduce mortality[[CiteRef::drayson2019le]]
	* [[Levofloxacin]] 500 mg p.o. daily for the first 12 weeks after starting chemotherapy may reduce mortality<ref>Drayson MT, Bowcock S, Planche T, Iqbal G, Pratt G, Yong K, Wood J, Raynes K, Higgins H, Dawkins B, Meads D, Hulme CT, Monahan I, Karunanithi K, Dignum H, Belsham E, Neilson J, Harrison B, Lokare A, Campbell G, Hamblin M, Hawkey P, Whittaker AC, Low E, Dunn JA; TEAMM Trial Management Group and Trial Investigators. Levofloxacin prophylaxis in patients with newly diagnosed myeloma (TEAMM): a multicentre, double-blind, placebo-controlled, randomised, phase 3 trial. Lancet Oncol. 2019 Dec;20(12):1760-1772. doi: [https://doi.org/10.1016/S1470-2045(19)30506-6 10.1016/S1470-2045(19)30506-6]. Epub 2019 Oct 23. PMID: [https://pubmed.ncbi.nlm.nih.gov/31668592/ 31668592]; PMCID: [https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31668592/ PMC6891230].</ref>

	[[Category:Hematology]]		[[Category:Hematology]]

Aidan at 13:09, 12 September 2022

2022-09-12T13:09:25Z

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 ** Anemia with hemoglobin &lt;100 g/L
 ** Bony lytic lesions
 == Diagnosis ==
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 ** Add low-dose whole-body CT or MRI for smoldering myeloma and solitary plasmacytoma
-== Complications ==
+== Management ==
 [[Category:Hematology]]

Maintenance script: Imported from text file

2020-07-04T01:17:46Z

Imported from text file

New page

== Definition ==

* Monoclonal proliferation of plasma cell line causing disease

== Classification ==

=== Monoclonal gammopathy of unknown significance (MGUS) ===

* M-protein present but <30 g/L, and
* Plasma cells <10% of bone marrow
* Absence of multiple myeloma end-organ damage
* If IgM, must also have no symptoms of a proliferative disorder or hyperviscosity
** Must think about Waldenstrom macroglobulinemia

=== Smoldering myeloma ===

* IgG or IgA M-protein >30 g/L or urinary M-protein (Bence-Jones) >500 mg/24h or plasma cells 10-60%
* Absence of multiple myeloma end-organ damage

=== Multiple myeloma ===

* SLiM CRAB symptoms
** Sixty percent plasma cells in marrow
** Light chain ratio (κ:λ or λ:κ) >100
** MRI showing at least two focal lesions
** Hypercalcemia >2.75 mmol/L
** Renal failure with creatinine >177 µmol/L or CrCl <40 mL/min
** Anemia with hemoglobin <100 g/L
** Bony lytic lesions

== Diagnosis ==

* Routine bloodwork
** CBC with peripheral blood film, for anemia
** Calcium and creatinine
** SPEP with immunofixation
** Quantitative immunoglobulins
** Urinalysis
** UPEP with immunofixation
* Bone marrow biopsy
* Imaging
** Bone survey including spine, pelvis, skull, humeri, and femurs
** Add low-dose whole-body CT or MRI for smoldering myeloma and solitary plasmacytoma

== Complications ==

* Acute kidney injury
** Light chain deposition
** Hypercalcemia
** Urate crystals
** Amyloid deposition
** Myeloma infiltration

[[Category:Hematology]]
[[Category:Oncology]]