Multiple myeloma in nurse practice

Multiple myeloma is a plasma cell tumor, the development of which is associated with the proliferation and accumulation of immunoglobulin-secreting terminally differentiated monoclonal B cells. A characteristic feature of the disease is the production by myeloma cells of a pathological protein – paraprotein. In developed countries, myeloma annually affects an average of 4 people per 100,000 populations. This disease develops due to the proliferation of myeloma cells in the bone marrow in the form of tumor growths. Bone tissue degradation occurs, as well as the accumulation of paraproteins in the blood, which leads to protein stasis in the vessels, increased blood viscosity and paraproteinemic coma. Clinical manifestations may be the result of bone damage, impaired immune function, changes in the kidneys, anemia, increased blood viscosity. A frequent clinical sign of multiple myeloma is the susceptibility of patients to bacterial infections due to hypogammaglobulinemia, a decrease in the production of normal antibodies. Obvious diagnostic signs of multiple myeloma are: foci of destruction, «target skull» and osteoporosis on the x-ray, typing of paraproteins in the blood and urine by immunofixation, determination of kappa and lambda light chains in the urine. A complete cure is impossible; they try to transfer the disease to the stage of remission. Alkylating cytostatic drugs are used: sarcolysin and cyclophosphamide; corticosteroid hormones (increase the effectiveness of chemotherapy), analgesic drugs. Radiation therapy may be used.