Multiple myeloma case

Chief complaint A 72-year-old male presents with lower back pain, and weight loss of 4 kg. Investigations Lumbar MRI & CT suggested the presence of lumbar spinal canal stenosis and a sacral tumor. raised serum IgG level 5,167 mg/dL (normal: 800–1,900 mg/dL) and raised serum beta-2 microglobulin level 4.5µg/mL (normal: 0–3 µg/mL), no anemia, renal dysfunction, or proteinuria. Bone marrow study shows numbers of CD135 +ve abnormal plasma cells. Diagnosis Cytogenetic analysis of the bone marrow shows 46XY, and the patient was diagnosed as having MM (R-ISS, stage II). Treatment Please give your views

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Case of multiple myeloma Stage2 with canal stenosis Diagnosed by urine checking for Ben den jons test positive Cancer cells in bones so fracture pneumonia Life expectancy 4 yr some live up to10 yr Opinion of oncologist orthopaedic

Treatment depends on stage Treatments include medication, chemotherapy, corticosteroids, radiation or a stem-cell transplant. Medications Chemotherapy, Blood transfusion, Steroid and Bone health Surgery Autotransplantation I agree with Dr Dibyjyotiji.. Molecular diagnostic for risk stratification must be reviewed thoroughly.

Ben zones proteins in urine are diagnostic for MM After confirmation Steroids orally Panetrating radiotherapy Chemotherapy

Thanx dr Johnson Sameer

Needs Molecular diagnostics for risk stratification. 17P del, TP53, and the translocations. Needs serum calcium level. Intial cycles of Bortezomib and Lenalidomide will play the role.

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