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형질세포 질환
경희의대 내과 윤휘중
혈액학 통합강의Multiple Myeloma
• malignant proliferation of plasma cells
• tumor, its product, host response -->
bone pain or fracture, renal failure,
susceptibility to infection, anemia,
hypercalcemia, clotting abnormality,
neurologic symptoms, hyperviscosity
syndrome
Medical Emergency:
cord compression, pathologic
fracture, hyperviscosity, sepsis,
hypercalcemia
POEMS syndrome
1. Polyneuropathy
2. Organomegaly
3. Endocrinopathy
4. Monoclonal gammopathy
5. skin change
Ig D 골수종
1) 발생연령이 낮다 . 2) 남성이 많다 . 3) extramedullary disease 가 많다 . 4) organomegaly 가 많다 . 5) total protein 의 양이 낮다 . 6) M-protein 의 peak 가 낮거나 없다 . 7) lambda 형 우위를 보인다 .Prognostic Factors in Multiple
Myeloma
• Patient factors:
A
ge
P.S.
Concomitant
illness
• Clinical Stage
• 2M
• IL-6, LDH, TK
• Morphological
factors:
plasmoblastic subtypes
plasma cell %
circulating plasma cell
• Cytogenetics, 13q del
• CRP, etc.
Event-free and overall survival times based on serum LDH levels at diagnosis and 13 in a group of 155 newly diagnosed myeloma
Event-free and overall survival times of 515 patients receiving autotransplants and a median follow-up of at least 5 years.
(1) M 단 백 : immunoelectrophoresis 또 는 immunofixation, electrophoresis
a) 혈청 : H 또는 L-chain 검사 , M 단백 정량 b) 소변 : 단백배설량 , M 단백 정량
(2) 골수검사 : 형질세포의 percentage, labeling index (3) 골격계 X- 선 조영술 : 골연화증 , 척추 압박골절 , 고립성
골수종 , 골용해 병소
(4) 생 화 학 적 검 사 : calcium, creatinine, 2-microglobulin
