Overview
Definition
Malignancy of plasma cells in the bone marrow.
Epidemiology
Most common primary bone cancer in adults > 50.
Etiology & Risk Factors
- Clonal proliferation of malignant plasma cells producing monoclonal immunoglobulins
Clinical Symptoms
- CRAB criteria: HyperCalcemia, Renal involvement, Anemia, Bone lytic lesions (back pain)
Clinical Approach
Diagnosis
- Serum Protein Electrophoresis (M-spike, IgG or IgA)
- Urine Bence Jones proteins
- Bone marrow biopsy (>10% clonal plasma cells)
Management
- Proteasome inhibitors (Bortezomib)
- Immunomodulators (Lenalidomide)
- Dexamethasone
- Autologous Stem Cell Transplant
Complications
- Pathologic fractures
- Renal failure
- Amyloidosis
- Infections