False regarding Multiple myeloma is:
Ref: Harrison's Principles of Internal Medicine, 18th editionExplanation:Multiple myelomaMultiple myeloma is a malignant proliferation of plasma cells derived from a single clone.CharacteristicsLytic hone lesionsAnemia with high ESRRoulex formation of red cellsRenal failure InfectionsHypercalcemiaTriad of Multiple myelomaMa now plasmacytos is >10%Lytic bone lesionsSerum and /or urine M componentMonoclonal plasma cells (k, A light chain restricted) in B\I or as a tumor (solitary plasmacytoma).End organ damage-Lytic bony lesions.Anemia.Hypercalcemia.Renal failure with paraprotenemia (mostly Ig G or Iga).S.electrophoresis for M band (b,g); Urine Bence Jones protein for light chainsNon secretory myeloma- no paraproteins, poor prognosisX-rays axial skeleton-skull, spine. long bones, ribs for lytic lesionsPET or MRI useful for early lesionsRadionuclide scan not usefulMust be differentiated from smoldering myeloma & MG USTreatment: Thalidomide/Ienolidamide + high dose dexamethasoneBortezomib. Autologous hematopoietic SCTLocalized RT for vertebral collapseBisphosphonates for malignant hypercalcemia (beware of their osteonecrosis jaw!)PrognosisStageb2 microglobulinAlbuminSurvivalStage 1<3.5mg/L> 3.5g/dL>5yrsStage 23.5-5.5mg/L Stage 3>5.5mg/L <2yrs
It is a calcified protein
Bence Jones protein in urine
Lytic bone lesions
Roulex formation of RBCs
Blood