Multiple Myeloma

• also known as myeloma or plasma cell myeloma. It is a progressive hematologic (blood) disease.

• It is characterized by excessive numbers of abnormal plasma cells in the bone marrow and overproduction of intact monoclonal immunoglobulin (IgG, IgA, IgD, or IgE) or Bence-Jones protein (free monoclonal κ and λ light chains).

• Hypercalcemia, anemia, renal damage, increased susceptibility to bacterial infection, and impaired production of normal immunoglobulin are common clinical manifestations of multiple myeloma.

• It is often also characterized by diffuse osteoporosis, usually in the pelvis, spine, ribs, and skull.


Assessment

• Headache and bone pain
• Pathologic fractures
• Skeletal deformities of sternum and ribs
• Osteoporosis
• Renal calculi
• Anemia
• Hypercalcemia
• Spinal cord compression


Management

• Analgesics for bone pain
• Chemotheraphy (cyclophosphamide)
• Antibiotics
• Gamma Globulins
• Corticostreriods
• Mithramycin
• Radiation Therapy
• Blood Transfusion
• Encourage ambulation to slow bone demineralization
• Encourage fluid intake (3-4 L/day)
• Avoidance of crowds or sources of infection


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