MULTIPLE MYELOMA - PLASMA CELL LEUKEMIA

60 Y Male with Severe backache, difficulty in walking due to pain, weakness, weight loss, appetite loss for last 4 to 5 months. His blood investigations are clinching the unique condition. Please go through blood reports as followed. Give your pinpoint diagnosis and discuss further management.

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This patient has a plasma cell dyscrasia. However, I am concerned about the plasma cells floating in blood, which is suggestive of a plasma cell leukemia (PCL). You should send a flow-cytometry to see if the plasmactyoid cells noted by the pathologist are actually malignant plasma cells. This is important to know as PCL is very aggressive, needs more aggressive therapy than garden variety multiple myeloma and if young patients need an allotransplant (vs auto transplant in multiple myeloma)

Multiple myeloma C----hyper calcemia-----Bone damage spine,ribs,skull R----Renal failure :Bence Jones proteinuria A----Anemia,d/t Normoblasts depletion B----Bleeding,d/t platelet depletion Screening-- serum electrophoresis-- M spike IOC: BONE MARROW BIOPSY RX: Dexamethasone+linalidomide+boretezomab TOC:bone marrow transplantation.

This seems to pe plasma cell leukemia which needs more aggressive therapy than RVD
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Plasma cell leukemia needs chemo and supportive therapy

High esr with anemia?? TB VERTIBRAL BODY?? ANKYLOSING SPONDYLITIS? ADV. MRI SPINE

Multiple myeloma