What is multiple myeloma


What is Multiple Myeloma

Multiple myeloma (multiple myeloma) -the most common bone tumor in adults. The average age of its appearance - 65 years, the incidence increases with age. The tumor usually shows multiple foci in multiple bones of the skeleton.

The basis of the tumor are plasma cellswhich normally are involved in the immune response to synthesize protective antibodies (immunoglobulins) in response to any antigen entering the body. When the number of multiple myeloma plasma cells in the bone marrow becomes excessive. These cells produce large amounts of a specific protein, which resembles normal antibodies. This protein is detected in blood and urine, and also deposited in internal organs.

How to recognize myeloma

What is multiple myelomaAn important difference from myeloma leukemias thatneoplastic plasma cells do not go into the peripheral blood. Therefore, the presence of tumor in the first place be judged by circumstantial evidence - the detection of atypical tumor protein in the blood and urine, as well as a change in the pattern of bone on x-ray.
The main diagnostic feature of tumoris a tumor protein, which is detected by electrophoresis in the blood and urine. This protein is similar in normal immunoglobulins, but is not involved in the immune response, and is deposited in the tissues of the body in the form of specific mass - amyloid. Most susceptible to amyloidosis of kidney, heart, and muscles, and the symptoms of their defeat will be gradually increasing renal, cardiac insufficiency, and muscle weakness.

In myeloma, X-ray examinationidentifies multiple "holes" in the bones of the skull, ribs. Since the action aimed at the tumor normal bone destruction and leaching therefrom of calcium and phosphorus, this leads to increased bone fragility.
As a result, a characteristic feature of the disease -multiple bone fractures in ordinary everyday situations, at low loads. Patients complain of pain in the bones, especially in the lumbar spine. Excess calcium from bones washed and pathological protein deposited in the kidney resulting in renal failure.

Renal disease - a key symptom of multiple myeloma - and it manifests itself in the amyloid deposits and occurrence of kidney stones.
On the X-ray or ultrasound of the pelvic organsfound stones in the kidney or bladder, and in the analysis of urine - increased calcium salt and myeloma protein that urine has its own name - Bence Jones protein, called a doctor for the first time it is detected. Protein in the urine can appear as a cylinder, taking the form tubules.

Another important clinical manifestationmultiple myeloma will be repeated infections. This happens because of the imperfect synthesis of immunoglobulin in the displacement of a tumor from normal bone marrow cells.

Final confirmation of the diagnosis of the tumor givesbone marrow puncture and histological examination. This procedure allows to see the tumor cells. Typical for multiple myeloma is a picture of the "eggs" in the bone marrow - the abundance of cells with a large dark nucleus, reminiscent yolk fried egg.

In the treatment of multiple myeloma is usedpharmacotherapy, combining drugs 3-5, depending on the degree of activity of the tumor, the presence of significant anemia and bone lesions. In some cases, use of bone marrow transplantation, radiotherapy as well as - for the local treatment of bone pain syndromes.

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