Multiple myeloma

Incurable
Etiology IgG in 60% of cases
MGUS = paraprotein below threshold and doesn't meet diagnostic criteria
Epidemiology M:F 5:3?
4-5 per 10000?
Clinical presentation 🦀 hypercalcaemia, AKI, anaemia, bone pain
Hyperviscosity, VTE
Amyloidosis
abnormal bleeding (as paraproteins interfere with platelet function)
Pathogenesis
Investigations: FBC: anaemia
Electrolytes: AKI; hypercalcaemia
Blood film: Rouleaux formation
Bone marrow: plasma cells
Other serum: ↑ free light chains; ↑ paraprotein (usually IgG); ↑ beta-2 microglobulin
Management: Generally considered incurable, with average survival 3-5 years, but...
- Induction therapy does exist
- Stem cell transplant?
- Bisphosphonates with bone disease