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multiple myeloma[′məl·tə·pəl ‚mī·ə′lō·mə]
a disease of the bone marrow of the group of plasma cell dyscrasias. It is caused by proliferation of genetically altered (mutated) plasma cells of the bone marrow which synthesize and release into the blood a large quantity of proteins with various physicochemical, biochemical, and immunochemical properties. Multiple myeloma is manifested by changes in the skeletal, hematopoietic, and uropoietic systems and by disturbances in protein and mineral metabolism. Spontaneous fractures and, sometimes, tumors originating in the bone marrow are observed. The bone resorption leads to hypercalcemia, and the excess calcium is deposited in the excretory organs (kidneys, lungs, gastric mucosa) in the form of calcifications. There is renal dysfunction (myeloma kidney) resulting mainly from filtration of abnormal proteins by the kidney. Frequent bacterial infections are characteristic of multiple myeloma because of the decrease in the number of normal immunoglobulins and the disruption of antibody formation.
Treatment consists of chemotherapy, irradiation, and hormonal therapy. Infection is treated by antibiotics and gamma globulin. Proper orthopedic measures are also of great value.
REFERENCESAlekseev, G. A., and N. E. Andreeva. Mielomnaia bolezn’. Moscow, 1966.
Kassirskii, I. A., and G. A. Alekseev. Klinicheskaia gematologiia, 4th ed. Moscow, 1970.
Burnet, F. M. Kletochnaia immunologiia. Moscow, 1971. (Translated from English.)
A. M. POLIANSKAIA