Plasma Cell Disorders- M AL-Asadi June 2024 PDF

Plasma Cell Neoplasms Dr Mazin Gh. Al-Asadi Consultant Haematologist MBChB, MSc, PhD, FRCPath (Haem)  Presentation objectives: ✓ Q: Outline the initial WORKUP investigations of newly diagnosed MM. ✓ Q: Discuss the PB and BM findings in MM. ✓ Q: List the important molecular and cytogen...

Plasma Cell Neoplasms Dr Mazin Gh. Al-Asadi Consultant Haematologist MBChB, MSc, PhD, FRCPath (Haem)  Presentation objectives: ✓ Q: Outline the initial WORKUP investigations of newly diagnosed MM. ✓ Q: Discuss the PB and BM findings in MM. ✓ Q: List the important molecular and cytogenetic findings in MM. ✓ Q: Discuss the SLiM-CRAB criteria. ✓ Q: Discuss the prognostic scoring systems in MM. ✓ Q: Discuss the 3 groups of MGUS? ✓ Q: Discuss mechanism of renal failure/anaemia in MM. Normal maturation of lymphoid cells and their neoplastic counterparts MM ALL Lymphomas + CLPD WHO 5th Classification of PCD  MM- Facts PCM (MM) is a malignant proliferation of plasma cells. Normal plasma cells are derived from B cells and produce immunoglobulins that contain heavy and light chains. Normal immunoglobulins are polyclonal, which means that a variety of heavy chains are produced and each may be of kappa or lambda light chain type. In myeloma, plasma cells produce immunoglobulin of a single heavy and light chain, a monoclonal protein commonly referred to as a paraprotein. In most cases an excess of light chain is produced, and in some cases only light chain is produced; this appears in the urine as Bence Jones proteinuria and can be measured in the urine or serum as free light chain. Frequency of presenting features in newly diagnosed myeloma 61% bone pain, 39% anaemia, 21% vertebral fracture, 20% renal dysfunction, 19% hypercalcaemia, 9% other fracture, 7% incidental diagnosis, 3% infections, 1% spinal cord compression.  MM Plasma Cell Smouldering Myeloma MGUS Myeloma (Multiple Myeloma) MM- IMWG updated criteria MM- IMWG myeloma defining evens  MGUS- IMWG updated criteria †Three variants of MGUS are now defined in the IMWG classification: Non-IgM MGUS, Light chain MGUS IgM MGUS. Light chain MGUS requires no immunoglobulin heavy chain on immunofixation, abnormal FLC ratio (1.65) with increased level of the appropriate involved light, urinary M-protein