Plasma Cell Disorders
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What is a plasma cell?
Plasma cell is b cell that is very active but you should not see them in circulation cuz they are indicative of very serious infection, produces lots of Ab
Describe the characteristics of a plasma cell disorder.
- Plasma cell disorders (plasma cell dyscrasias, monoclonal gammopathies) are conditions in which one group (clone) of plasma cells multiplies excessively and produces a large quantity of abnormal antibody-like molecules.
- Antibodies don't help protect the body against infections.
- Normal antibody production often decreases, making a person more susceptible to infections.
- Abnormal plasma cells invade and damage various tissues and organs.
- Hyperviscosity- blood gets real thick, tend to coat RBC causing Rouleux
Name 8 types of plasma cell disorders.
- 1.Multiple Myeloma
- 2.Waldenstrom's Macroglobulinemia
- 3.Solitary Bone Plasmacytoma
- 4.Extra Medullary Plasmacytoma
- 5.Osteosclerotic Myeloma (POEMS Syndrome)
- 7.Heavy Chain Disease
- 8.Monoclonal gammopathy of undetermined significance/smoldering multiple myeloma.
Describe monoclonal gammopathies of undetermined significance (type of plasma cell disorder).
- plasma cells are abnormal but not cancerous
- large quantity of abnormal antibodies
- Remain stable for years--as long as 25 years in some people--and don't require treatment
- More common in older people.
- disorders progress to multiple myeloma, 20-30%
What is multiple myeloma?
Multiple myeloma is a plasma cell cancer in which a clone of abnormal plasma cells multiplies, forms tumors in the bone marrow, and produces a large quantity of abnormal antibodies that accumulate in the blood or urine.
Multiple myeloma accounts for what percentage of all cancers in the US and how many new cases are diagnosed every year?
What is the cause of multiple myeloma and who is usually affected by it?
- cause is unknown
- affects men and women equally
- usually seen in people over 40 yrs old
Where are the most common places that plasma cell tumors (plasmacytomas) are found?
- 1.pelvic bones
- 6.reproductive organs
People with multiple myeloma have abnormal antibodies. What can this lead to?
- People who have multiple myeloma are especially susceptible to infections
- Abnormal antibodies frequently end up in the kidneys, sometimes causing kidney failure.
- Deposits of antibody pieces in the kidneys or other organs can lead to amyloidosis
- Abnormal antibody pieces in the urine are called Bence Jones proteins. TEST QUESTION
What are the abnormal antibody pieces in the urine of patients with multiple myeloma called? TQ
What are 6 resulting symptoms of multiple myeloma?
- 1.Bone pain, especially in the spine or ribs
- 2.Weakens bones, which may fracture easily.
- 4.Recurring bacterial infections
- 5.Kidney failure develops.
- 6.blood flow to the skin, fingers, toes, and nose (Blood Thickening)
Describe key lab findings associated with multiple myeloma.TEST QUESTION Case study
- 1.CBC - Anemia and abnormal RBC’s
- 2.High ESR
- 3.Calcium levels are abnormally high because changes in the bone result in calcium leaking into the bloodstream. 4.Biopsy proven plasmacytoma
- 5.>30% Plasma Cell in Bone Marrow
- 6.Monoclonal Protein (M-Spike)
- >3.5 g/dL of serum IgG
- >2.0 g/dL of serum IgA
- 7.Multiple lytic bone lesions
- 8.Low Normal Immunoglobins
Describe 6 characteristics of macroglobulinemia.
- 1.Hyperviscosity syndrome
- 2.reduced blood flow to the skin, fingers, toes, and nose as well as a variety of other symptoms.
- 3.abnormal bleeding from the skin and mucous membranes
- 4.fatigue, weakness, headache, dizziness, and even coma.
- 5.The thickened blood also may aggravate heart conditions and cause increased pressure in the brain.
- 6.Tiny blood vessels in the back of the eyes can become engorged and may bleed, resulting in damage to the retina and impaired eyesight.
What is cryoglobulinemia?
- A condition characterized by cryoglobulins, which are abnormal antibodies that precipitate in the blood when cooled below body temperature and dissolve when warmed.
- People who have cryoglobulinemia may become very sensitive to cold or develop Raynaud's phenomenon, in which the hands and feet become very painful and turn white when they're exposed to cold.
What is heavy chain disease?
Neoplastic plasma cell dyscrasias characterized by overproduction of monoclonal immunoglobulin heavy chains.
Name and describe 3 heavy chain diseases.
- Gamma HCD IgG
- Liver, Spleen, Lymph Nodes
- Disease of Elderly People
- Alpha HCD IgA
- Abdominal Mass – GI Tract
- Younger individuals in the Mediterranean
- Mu HCD IgM
- CLL association I Lymphs, vacuoulate plasma cells
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