blood disorders

what is multiple myeloma

malignant proliferation of plasma cells in the bone marrow. caused by overproduction of monoclonal immunoglobin

risks for multiple myeloma

age over 60

genetic factors

enviornmental chemical and radiation exposure

chronic inflammation

male

african america'n

obesity and sedentary lifestyle

S&S of multiple myeloma (CRAB)

hyperCalcemia

renal dyfunction

Anemia

bone pain

diagnostics for multiple myeloma

• CBC to checek for anemia

• serum protein electrophoresis to find M protein

• urine analysis for bence jones protein

• serum calcium and creatinine levels

• bone scans for lytic lesions

• bone marrow biopsy to determine presence of malignant cells

what lab results are indicators of multiple myeloma

lytic lesions on a CT or MRI

increased M protein in a serum electrophoresis

bence jones proteins in urinalysis

hyper calcemia levels

renal impairment levels

anemia levels

greater than 2.25’

creatinine greater than 177

hgb less than 100g/liter

Meds for multiple myeloma

chemotherapy like cyclophosphamide

targeted therapy like protease inhibitors

monoclonal antibodies

stem cell transplant

education for ppl with multiple myeloma

take lots of water to wash out the calcium

take calcium supplements

monitor for anemia and hypercalcemia

injury prevention

lymphoma vs leukemia

lymphoma: abnormal proliferation of lymphocytes (lymph cells)

leukemia: abnormal, malignant leukocytes (WBCs)

causes of lymphoma

genetic mutation and EB virus infection

risks for leukemia

age, genetic disorders, previous chemo or radiation therapy, exposure to certain chemicals

what does lymphoma result in

adenopathy,

fever

night sweats

weight loss

fatigue

chest pain

itching

what does leukemia result in

anemia

leukopenia

thrombocytopenia

increased infections

bruising

bleeding

bone pain,

tenderness

diagnosing malignant lymphoma

lymph node biopsy

imaging

blood tests

leukemiea diagnostics

blood test

bone marrow biopsy

flow cytometry - determines type of cancerous blood cells based on cell markers

treatment for lymphoma and leukemia

chemo

targeted therapy

radiation - for localized lymphoma

stem cell transplant

things to look out for with patients

anemia, infection, bleeding

what is myelodysplastic syndrome

hematopoetic stem cells dont make blood cells properly, and result in blood cytopenias and malformed cells

results in

anemia, pancytopenia

causes of secondary MDS

risks

chemo, radiation, toxin exposure, viral infections

age over 60

male

family history

exposure to chemicals

previous cancer or blood conditions

signs and symptoms of myelodysplastic syndrome

pancytopenia leading to

• anemia

• pale skin

• decreased clotting (*lack of platelets)

• bruising

• increased infections

• tired/weak

• difficulty breathing

fever

night sweats

bone pain

splenomegaly

diagnostics

blood test

bone marrow biopsy

cytogenic analysis to see what the genetic cause is for the disease

supportive care for myelodysplastic syndrome

blood transfusions- help with symptoms

growth factors like erythropoetin

disease modifying treatments

hypomethelatying agents

immunomodulatory drugs

curative treatment

stem cell transplant

what are hypothalmating agents

agents that insert themselves into cell DNA and prevent methylating action, which causes apoptosis of the damaged cell. using these can help prevent proliferation and dissemination of damaged cells in myelodysplastic syndrome. they also end up ‘turning on’ tumor suppresor genes that would prevent malignancy

azacitidine

decitabine

what are erythopoeisis stimulating factors

stimulate RBC growth

• epoetin alfa

• darbapoetin alfa

what are myeloid growth factors

filgastrin

pegfilgastrin

sargrastim

stimulate production of WBCs

what are thrombopoetic growth factors

produce more platelets

ILL 11

romiplosten eltrombopag