Multiple Myeloma

Multiple Myeloma

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Pathology is characterized by the clonal proliferation of plasma cells, which usually produce monoclonal immunoglobulins, commonly referred to as paraprotein, or part of an immunoglobulin, such as the light chains. These cells are also known to promote an excess of osteoclastic activity.


A weak association with factors such as radiation, benzene, pesticide exposure, and farm working has been observed.


Often, this condition presents itself without outward symptoms, though pain resulting from the lytic lesions or pathological fractures is possible. It is also possible to experience blurred vision, headaches, hypercalcaemia, or renal failure.


Signs of pathology can include bleeding, bruising, purpura, pallor, and bony tenderness.


  • Bloods: A full blood count, urea and electrolytes, calcium, liver function tests, erythrocyte sedimentation rate, C-reactive protein, and serum free light chains can be examined.
  • Serum Electrophoresis: Paraproteins can be detected.
  • Blood Film: Rouleaux formation – RBCs sticking together can be observed.
  • MSU: Bence Jones protein (light chains present in urine) can be observed.
  • Imaging: A skeletal survey may show “punched out�_ lesions in the skull.
  • Bone Marrow Aspirate: Plasma cell infiltration can be detected.


Medical treatments may include analgesia, antibiotics, intravenous fluids, bisphosphonates, radiotherapy, chemotherapy, allogenic stem cell transplantation, and plasmapheresis.


Pathology can result in infection, anaemia, bleeding, hair loss, gastrointestinal toxicity, organ damage, renal failure, amyloidosis, spinal cord compression, or bone fractures.


The median survival rate is approximately five years.

Text Box: Common Symptoms Of Multiple Myeloma Mnemonic   ‘CRAB’    Calcium elevated  Renal Failure  Anaemia  Bone Lesions

The acronym ‘CRAB’ is a mnemonic for the common symptoms associated with multiple myeloma: Calcium elevated, Renal Failure, Anaemia, Bone Lesions.

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