LBSC - Plasma Cell Disorders

What is the final stage of B cell lymphocyte development?

Plasma Cell

Plasma cells requires antigen dependent or independent maturation?

Dependent

Where do plasma cells move to from the secondary lymphoid organ for maturation?

Bone Marrow

What cell has the main function of producing antibodies?

Plasma Cells

How long do plasma cells live?

1 month

Which heavy chain does IgG have?

Gamma

Which heavy chain does IgM have?

Mu

Which heavy chain does IgA have?

Alpha

Which heavy chain does IgD have?

Delta

Which heavy chain does IgE have?

Epsilon

What is the hallmark of plasma cell disorders?

Immunoglobulin Overproduction

Serum protein and albumin measurement allow us to approximate what?

Immunoglobulin

What separates the serum proteins into albumin, alpha, beta, and gamma globulins?

Electrophoresis

Increased immunoglobulins show in which region of electrophoresis?

Gamma

What origin type is Abs derived from single ancestral cell?

Monoclonal

What origin type is Abs derived from more than one Ab producing parent cell?

Polyclonal

Spike caused by monoclonal Ig is called what?

Monoclonal Spike

Further identification of the M-spike proteins is carried out by what?

Immunofixation

What is it when migrate 5 separate lanes, mono-specific Ab are added and mono-specific antibodies bind to antigen of serum antibodies and complex?

Immunofixation

What quantitates immunoglobulin where patient serum is mixed with specific reagent to create Ag-Ab complexes?

Rate Nephlometry

What causes light scatted which is measured in rate nephelometry?

Ag-Ab

What helps us accurately quantitate Ig, but does not assess monoclonality?

Rate Nephelometry

Imbalanced Ig production most frequently yields excess what?

Free Light Chains

An increased production of free light chains (FLC) leads to filtration into urine called?

Bence-Jones proteinuria

What can deposit into kidneys that leads to more leakage of protein into urine?

FLC

What is it when excess immunoglobulin causes blood to become viscous?

Hyperviscosity Syndrome

What causes higher resistance to flow in blood vessels, decreased blood flow in small vessels of vital organs, and increased workload on the heart?

Hyperviscosity Syndrome

What treatment is used for symptomatic patients that have hyperviscosity syndrome?

Plasma Exchange

What leads to symptoms of confusion, headache, dementia, disturbances of consciousness, stroke, and/or coma?

Hyperviscosity Syndrome

What leads to increased susceptibility to infections, especially causing respiratory infections?

Decreased Production of Normal Immunoglobulin

What is the leading cause of death in multiple myeloma patients?

Infection

What can help decrease frequency of infections with patients who have decreased production of normal immunoglobulin?

IV Infusions

What are serum immunoglobulins that precipitate reversibly on exposure to cold temps?

Cryoglobulins

What is the most common plasma cell disorder?

Multiple Myeloma (MM)

What group of patients does Multiple Myeloma affect (MM)?

Older Patients

What stays localized in BM until late in disease of Multiple Myeloma (MM)?

Plasma Cells

What major symptoms does Multiple Myeloma (MM) have?

Anemia, Bone Pain, Polyuria, Nausea, & Increased Infections

Which type of plasma cell disorder is a single plasma cell establishes a malignant clone and then the malignant cell proliferates into plasma cell colonies?

Multiple Myeloma (MM)

When malignant plasma cells start replacing normal BM in Multiple Myeloma (MM), what occurs first?

Anemia

When malignant plasma cells start replacing normal BM in Multiple Myeloma (MM), what occurs second?

Thrombocytopenia

When malignant plasma cells start replacing normal BM in Multiple Myeloma (MM), what occurs third?

Neutropenia

The microenvironment of what supports the malignant plasma cells and promotes growth and prevents apoptosis in Multiple Myeloma (MM)?

Bone Marrow

Myeloma cells adhere to what cells inducing cytokine secretion which mediate the disease?

Stromal Cells

What stimulate tumor necrosis factor-related induced cytokine (TRANCE) in Multiple Myeloma (MM)?

Osteoclast activating cytokines

What usually blocks tumor necrosis factor-related induced cytokine (TRANCE) in Multiple Myeloma (MM)?

Osteoprotegerin (OPG)

What activates osteoclasts which absorb bone?

TRANCE

What part of Multiple Myeloma (MM) results from disturbed balance of bone formation and absorption?

Bone Disease

What part of Multiple Myeloma (MM) is increased bone turn-over leads to calcium being released in the blood?

Hypercalcemia

What balance plays a critical role in regulation of cellular function?

Calcium

Which plasma cell disorder has Rouleaux due to excess Ig in plasma?

MM

With Multiple Myeloma (MM), is there an increase or decrease in sedimentation rate?

Increase

With Multiple Myeloma (MM), is there an increase or decrease in calcium levels?

Increase

For Multiple Myeloma (MM) electrophoresis, where is the monoclonal peak?

Gamma Region

The production of what is inhibited by cytokines secreted?

Albumin

What cells have abundant glycoprotein and ribosomes that give cell intense staining?

Flame Cells

What cells contain multiple Russell bodies?

Mott Cells

What are inclusions containing immunoglobulins known as?

Russell Bodies

Which chromosome translocations is the most common in Multiple Myeloma (MM)?

14

Which band translocations is the most common in Multiple Myeloma (MM)?

q32

Chromosome 14 band q32 is the site of what?

Immunoglobulin heavy chain locus

What is a rare multiple myeloma defined as pancytopenia and increased plasma cells?

Plasma Cell Leukemia

What is the lymphoproliferative disorder of plasmacytoid lymphocytes caused by IgM monoclonal immunoglobulins?

Waldenström’s Macroglobulinemia

In which plasma cell disorder is caused by IgM coating platelets impeding their function and causing complications?

Waldenström’s Macroglobulinemia

Which plasma cell disorder has a small M-spike with normal levels of uninvolved Ig?

Monoclonal Gammopathy of Undetermined Significance (MGUS)

Is Monoclonal Gammopathy of Undetermined Significance (MGUS) malignant or nonmalignant?

Nonmalignant