Multiple Myeloma

Yen H. Phan, DO and Nida (Joy) Emko, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Multiple myeloma (MM) is a clonal proliferation of malignant plasma cells.

  • This clonal proliferation in the bone marrow (BM) can cause extensive skeletal destruction with osteolytic l...

DIAGNOSIS

HISTORY

  • 34% of patients are asymptomatic at the time of presentation.

  • Hypercalcemia (28%): anorexia, nausea, somnolence, and polydipsia

  • Elevated creatinine (48%)

  • Anemia (73%)

  • Bony lesions (80%): ...

TREATMENT

  • Treatment varies depending on level of disease activity and stage of MM.

  • Key determinant factor in choosing chemotherapy regimen is to establish if the patient is an autologous stem cell tran...

ONGOING CARE

PATIENT EDUCATION

PROGNOSIS

  • Median survival overall is 3 years. The 5-year survival rate is around 35...

REFERENCES

1 Palumbo A, Anderson K. Multiple myeloma. N Engl J Med.  2011;364(11):1046–1060.  [View Abstract]
2 Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group...

ADDITIONAL READING

  • Grass S, Preuss KD, Thome S, et al. Paraproteins of familial MGUS/multiple myeloma target family-typical antigens: hyperphosphorylation of autoantigens is a consistent finding in fa...

CODES

ICD10

  • C90.00 Multiple myeloma not having achieved remission

  • C90.01 Multiple myeloma in remission

  • C90.02 Multiple myeloma in relapse

ICD9

  • 203.00 Multiple myeloma, without mention of having achieved re...

CLINICAL PEARLS

  • MM is a plasma cell malignancy that causes end-organ damage.

  • Look for presence of “CRAB” (hypercalcemia, renal insufficiency, anemia, and bone lesions).

  • Suspect MM if high total protein-...

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