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Multiple Myeloma

Nida (Joy) Emko, MD, FAAFP Reviewed 06/2019
 


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, abdominal pain, somnolence, polydipsia, polyuria, dehydration

  • Elevated creatinine (48%)

  • Anemi...

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

  • The 5-year survival rate is around 50%.

  • Median survival by R-ISS stage:

    • Stage I: has ...

REFERENCES

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

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.”

  • Suspect MM if high total protein-to-albumin ratio is present.

  • Maintain high index of suspicion fo...

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