Diagnosing and treating Multiple Myeloma

There are many patients who are said to suffer from multiple Myeloma. Hence, it becomes essential on their part to get it diagnosed from the leading physician in the region and to get the most appropriate treatment. Only then can they get relief and do away with the pain associated with this ailment that is only possible with timely and proper treatment. But before going ahead with the treatment of this type of ailment, it will be useful to first know about it. Being educated will help the person to get the best possible treatment and to take correct and wise decisions.
Some facts to know about the disease
  • Peak incidence is between the ages of 60 and70 years.
  • It is considered to be a malignant disorder related to plasma cells.
  • Males are found to be affected more when compared to females.
  • It is found to be rare among people under 30 years of age.
Pathogenesis
  • An abnormal immunoglobulins (paraprotein) type generally IgA or IgG.
  • The tissue gets infiltrated with proliferating cells.
  • The coagulation factors and platelets could be coated by paraprotein.
  • Auto-immune manifestations may be caused due to paraprotein.
  • Incomplete immunoglobulin production by plasma cells (light chain only) that gets excreted with urine (Bence – Jones protein)
  • Risk of Infection growth with reduced normal immunoglobulin production.

Clinical picture:
  • Skeletal:
    • Osteoclast stimulation and multiple osteolytic lesions within the skull region.
    • Pathological fractures and bone aches
  • Neurological:
    • Plasma cell infiltration in muscles, nerves and roots.
    • Spinal cord compression by vertebral lesion.
  • Renal Failure caused by:
    • Nephrocalcinonsis due to hypercalcaemia
    • Bence – Jones Proteins precipitated within the kidney region
    • Amyloidosis in kidney region
    • Hyperuricaemia because of plasma cell destruction
    • Pyelonephritis because of susceptibility to infections
  • Anemia because of:
    • Plasma cell replacement of bone marrow.
    • BM inhibition through radiotherapy and chemotherapy
    • Renal impairment
    • Haemolysis due to paraprotein
  • Bleeding tendency because of:
    • Coagulation factor coating by paraprotein
    • Platelet coating by paraprotein
  • Cardio-vascular:
    • Hyperviscosity syndrome
    • Raynoud’s phenomenon because of cold antibodies
  • Others:
    • Amyloidosis
    • Repeated infections
Investigations
  • Blood picture:
    • Increased ESR
    • Anemia
  • BM examination:
    • Complete with plasma cells
  • Biochemical:
    • Normal alkaline phosphatase
    • Increase in uric acid within blood
    • Increase in calcium in blood
  • Immune electrophoresis:
    • Displays marked increase in a particular immunoglobulins type
  • Renal:
    • Kidney function exam could be impaired
    • Urine electrophoresis for light chains and paraprotein
    • Bence – Jones proteins
  • X-Ray:
    • Multiple osteolytic lesions within bones with more affected being the pelvis, skull and vertebrae
Treatment provided
  • Chemotherapy:
    • Cyclophosphamide or Melphalan
  • Radiotherapy:
    • For controlling tumor masses
  • Symptomatic:
    • For example, renal pain and failure, infection
One can get the very best treatment for myeloma in India at affordable rates and recover quickly.
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