Plasma Cell Dyscrasias

abnormal clonal proliferation of immune globulin-secreting differentiated B lymphocytes and plasma cells;

they include:

1. Multiple Myeloma (the most common)
2. Monoclonal Gammopathy of Undetermined Significance (MGUS)
3. Waldenstrom macroglobulinemia, and
4. Light-chain-associated amyloidosis (AL amyloidosis)

Multiple Myeloma

the chief plasma cell dyscrasia (PCD)

Features:

• Bone pain - the most common presentation (from pathologic fractures)
  • due to osteoclast activating factor (OAF), IL-1 and IL-6, which attacks bone, causing lytic lesions and hypercalcemia
• Anemia (normochromic, normocytic)
• Infections due to impaired immunoglobulin production,
• AL amyloidosis due to accumulation of monoclonal Ig light chains, and
• renal failure (the most common causes of death in myeloma)
• mnemonics - "CRAB"
• Calcium (Ca2+ >10.5)
• Renal (Creat. >2)
• Anemia (Hb <10 or <2g below baseline)
• Bone (lytic bone lesions or osteoporosis)