| Περίληψη: | Multiple Myeloma is a plasmacytic neoplasia resulting from an unjustified, unnecessary and uncontrollable proliferation of one clone of plasmacytes in the marrow (rarely elsewhere) with the following consequences : (a) inhibition of the growth of the other cell series (hence anemia and thrombocytopenia), (b) bone destruction (osteoporosis, osteolytic lesions and hypercalcemia), (c) an increase of the monoclonal immunoglobulin in the plasma in association with the expected hyperviscosity and disturbed microcirculation, (d) progressive renal deterioration mainly due to the abundant excretion of free light chains (Bence Jones proteins), and (e) a decrease of normal immunoglobulins leading to increased susceptibility to infection. All of the above appear in various combinations and degrees of severity. The diagnosis is based on an array of morphological, caryotypic, biochemical and molecular parameters; the latter are also offering a certain insight into the underlying pathogenetic mechanisms. Therapy is complex but effective as a rule; it comprises cytostatics, immunomodulators and targeted medications, as well as autologous stem cell transplantation following megatherapy.
|
|---|
