Multiple myeloma natural history: Difference between revisions
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==Complications== | ==Complications== | ||
Complications that can develop as a result of [[multiple myeloma]] are divided into:<ref name="Bladé-2007">{{Cite journal | last1 = Bladé | first1 = J. | last2 = Rosiñol | first2 = L. | title = Complications of multiple myeloma. | journal = Hematol Oncol Clin North Am | volume = 21 | issue = 6 | pages = 1231-46, xi | month = Dec | year = 2007 | doi = 10.1016/j.hoc.2007.08.006 | PMID = 17996596 }}</ref> | |||
* | :*'''Local complications:''' | ||
* Hematologic complications, usually results from the replacement of normal bone marrow by infiltrating tumor cells and inhibition of normal ([[hematopoiesis]]) by [[cytokines]] | ::* Hematologic complications, usually results from the replacement of normal bone marrow by infiltrating tumor cells and inhibition of normal ([[hematopoiesis]]) by [[cytokines]] | ||
:* Normocytic and normochromic[[anemia]] | :::* Normocytic and normochromic [[anemia]] | ||
:* | :::* Bleeding disorders | ||
:* | :::* [[Pancytopenia]] due to bone marrow failure | ||
::* Skeletal complications | |||
:* Pathologic fractures | :::* Pathologic fractures | ||
:* [[Spinal cord compression]] present as back pain, numbness, [[dysthesias]] suggestive, loss of bowel or bladder control. | :::* [[Spinal cord compression]] present as back pain, numbness, [[dysthesias]] suggestive, loss of bowel or bladder control. | ||
* Neurologic complications | |||
:* [[plasmacytoma|Intracranial plasmacytomas]] | :*'''Systemic complications:''' | ||
:* [[Leptomeningeal]] involvement | ::*[[Hypercalcemia]] | ||
:*[[Retinopathy]] | ::*[[Renal failure|Renal insufficiency]], may develop both [[acute renal failure|acutely]] and [[chronic renal failure|chronically]]. | ||
:*[[radicular pain]] | ::*Neurologic complications | ||
:*[[Carpal tunnel syndrome]] | :::*[[plasmacytoma|Intracranial plasmacytomas]] | ||
:*[[Paraplegia]] | :::*[[Leptomeningeal]] involvement | ||
* Infections | :::*[[Retinopathy]] | ||
:*[[Pneumonia]]s | :::*[[radicular pain]] | ||
:*[[Pyelonephritis]] | :::*[[Carpal tunnel syndrome]] | ||
:::*[[Paraplegia]] | |||
::* Infections | |||
:::*[[Pneumonia]]s | |||
:::*[[Pyelonephritis]] | |||
==Prognosis== | ==Prognosis== | ||
Revision as of 20:10, 18 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A number of organ systems are commonly involved in multiple myeloma including renal failure, hematologic complications, infections, bony and neurological complications; the most common of which being bone pain usually involving the spine and the ribs. Bone involvement leads to pathological fractures and resultant hypercalcemia. Infections such as pneumonias and pyelonephritis are also common complications of multiple myeloma. Renal failure from hypercalcemia and Bence Jones protein filtration, anemia from suppressed bone marrow production and neurological symptoms from brain metastasis are also prominent. According to a report published by National Cancer Institute there is a 43.25 chance of 5 year survival.[1]
Natural History
Complications
Complications that can develop as a result of multiple myeloma are divided into:[2]
- Local complications:
- Hematologic complications, usually results from the replacement of normal bone marrow by infiltrating tumor cells and inhibition of normal (hematopoiesis) by cytokines
- Normocytic and normochromic anemia
- Bleeding disorders
- Pancytopenia due to bone marrow failure
- Skeletal complications
- Pathologic fractures
- Spinal cord compression present as back pain, numbness, dysthesias suggestive, loss of bowel or bladder control.
- Systemic complications:
- Hypercalcemia
- Renal insufficiency, may develop both acutely and chronically.
- Neurologic complications
- Infections
Prognosis
- Overall mortality rates peaked in the mid-1990s and have fallen in recent years.[3]
- The average survival of multiple myeloma patients is approximately 3 years and approximately 43.5% of patients survive after 5 years.
- The International Staging System can help to predict survival, with a median survival of 62 months for stage 1 disease, 45 months for stage 2 disease, and 29 months for stage 3 disease.
- Cytogenetic analysis of multiple myeloma cells may be of prognostic value, with deletion of chromosome 13, non-hyperdiploidy and the balanced translocations t(4;14) and t(14;16) conferring a poorer prognosis. The 11q13 and 6p21 cytogenetic abnormalities are associated with a better prognosis.
- Prognostic markers such as these are always generated by retrospective analyses, and it is likely that new treatment developments will improve the outlook for those with traditionally 'poor-risk' disease.
References
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Bladé, J.; Rosiñol, L. (2007). "Complications of multiple myeloma". Hematol Oncol Clin North Am. 21 (6): 1231–46, xi. doi:10.1016/j.hoc.2007.08.006. PMID 17996596. Unknown parameter
|month=ignored (help) - ↑ A snapshot of myeloma. National cancer institute(2014)http://www.cancer.gov/research/progress/snapshots/myeloma