Writer : Nusrat Surobhi

Topic : Multiple myeloma.

🔴 What is Multiple myeloma?

It is a chronic, progressive and fatal malignant condition in which the fundamental abnormality is a neoplastic proliferation of plasma cells which infiltrate the bone marrow, and often other body tissue.

অর্থাৎ, সেই যে ছোটবেলায় Totipotent stem cell এর কথা পড়েছিলাম, সেখান থেকেই তৈরি হওয়া lymphoid series এর B lymphocyte এর পরবর্তী stage – plasma cell এর যদি abnormal proliferation হয়, তখন সেই condition টাকে বলা হয় Multiple myeloma.

💠 Multiple Myeloma এর সাথে সাথে যে টপিক টি চলে আসে, সেটি হলো Paraprotein.
🔴 What is paraprotein?

• It is one type of immunoglobulin molecule or one type of heavy chain or light chain which is produced under neoplastic proliferation of monoclonal cells of lymphoid series.

🔷 Immunoglobulin light chain either kappa or lambda কে বলা হয় Bence – Jones protein

Multiple Myeloma তে এই Bence Jones paraprotein present থাকে।

🔶 তাহলে, এবার জেনে নেওয়া যাক, Multiple myeloma তে Patient কি কি clinical feature নিয়ে আসবে।

🔺Age : in between 50-70 years.
🔺Bone pain, osteoporosis, osteolyyic lesion & pathological fracture.
🔺Anaemia, weakness, lethergy.
🔺Renal failure
🔺Skeletal deformity
🔺Tumor formation
🔺Bleeding manifestation
🔺Infection
🔺Cryloglobuliaemia.

🧐Laboratory Diagnosis:-

📌 Blood picture :-
🔳Hb% : Reduced
🔳ESR : High (Sky rise due to rouleaux formation)
🔳Red cell : Anaemia ( Normocytic normochromic,marked rouleaux formation.
🔳 WBC: Leukopenia
🔳Platelet : Decreased

📌 Bone marrow examination:-

🔷 Cellularity : Hypercellular
🔷M/E ratio : Increased
🔷 Plasma cell: More than 30%

📌 Blood biochemistry:-

🔺 Total serum protein : Increased due to presence of paraprotein.
🔺Serum calcium – Increased
✴️ Confirmatory test : Immuno electrophoresis – serum for M protein.

🔲 Urine : Bence Jones protein is present
⭕ X -ray of bone : Punched out lesion.

🔶 Treatment :-

• Immunotherapy.
• Chemotherapy
• Radiotherapy
• Bone marrow transplant.

Edited By : Nahid Hassan.