Multiple Myeloma

Multiple myeloma (mm) is a malignant proliferative disease of plasma cells. There is no common alias for this disease. It is characterized by uncontrolled proliferation of plasma cells in the bone marrow and the secretion of monoclonal immunoglobulin, which eventually causes damage to organs or tissues. The incidence of this disease in men is higher than that in women. The incidence of mm is lower than that in western countries, but it increases year by year, and there is a certain genetic correlation. The risk of mm in the immediate family members of patients is higher. The mortality and prognosis were significantly different, and the median survival time was about 3-4 years.

Figure 1. Multiple Myeloma.

Overview

The clinical symptoms of multiple myeloma are diverse, and the most classic quadruple sign (crab) is: elevated blood calcium, renal dysfunction, anemia, bone pain. Other symptoms include paresthesia, hepatosplenomegaly, lymphadenopathy, fever, etc. Bone pain is often chest pain and low back pain, with obvious symptoms after exercise. It is worth noting that multiple myeloma is not an infectious disease and is not infectious. The treatment of multiple myeloma is not limited to, but generally includes general treatment, drug treatment, surgical treatment, etc. General treatment includes the use of bisphosphonates to control bone destruction, active calcium reduction to treat hypercalcemia, dialysis to treat end-stage renal failure, etc. The use of bortezomib, lenalidomide and other chemotherapeutic drugs are common methods of drug treatment, and the treatment plan should be individualized according to the patient's disease condition and physical condition. In addition, for patients who are suitable for it, autologous hematopoietic stem cell transplantation can also be performed. Surgical treatment is mainly used for the treatment of pain that cannot be controlled by drug methods and the treatment of extramedullary infiltration foci of myeloma. The prognosis is different due to individual differences, but recurrence is inevitable, and follow-up is required.

Disease type

According to the type of immunoglobulin secreted by myeloma cells, the disease can be divided into the following types: IgG type, IgA type, IgD type, IgM type, IgE type, light chain type, double clone type and non secretory type. It can also be further divided into κ type and λ type according to the light chain type. The clinical staging criteria of multiple myeloma include the traditional Durie salmon (D-S) staging system, the international staging system and the revised international staging system. Although the clinical items of staging are different, they are all divided into stages I, II and III according to the severity. In the D-S stage, according to whether the renal function is normal or not, it is divided into subtypes A and B.

Etiology

• Basic etiology

At present, it is not clear. However, molecular and cellular genetic abnormalities are closely related to the pathogenesis of multiple myeloma. Radiation exposure, viral infection and exposure to certain chemicals are considered to be involved in the pathogenesis of multiple myeloma, but there is no direct evidence.

• Predisposing factors

The risk factors related to the incidence of MM are still unclear. Epidemiological data show that the incidence of MM is related to gender, age and race. Occupational environment, lifestyle, ionizing radiation, exposure to chemical poisons, chronic antigen stimulation, autoimmune diseases, drugs, viral infection, etc. may be involved in the pathogenesis of mm, and the specific mechanism is still controversial.

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