Müeloomid

Müeloomid are a group of plasma cell neoplasms characterized by clonal proliferation of malignant plasma cells, most often within the bone marrow. The best known member is multiple myeloma, a disease that can disrupt normal blood cell production and bone remodeling. Other forms include solitary plasmacytoma (a single lesion) and extramedullary plasmacytoma (plasma cell tumors outside the bone marrow).

Pathophysiology typically involves expansion of a single clone of plasma cells that produce a monoclonal immunoglobulin (M protein), detectable in blood or urine. These malignant cells create bone lesions through increased osteoclast activity and can cause anemia, immune dysfunction, and renal impairment due to light-chain deposition or high protein load. Common clinical features include bone pain, fatigue, recurrent infections, anemia, and sometimes hypercalcemia.

Diagnosis relies on a combination of laboratory, bone marrow, and imaging studies. Blood and urine tests detect M protein and abnormal free light chains; bone marrow biopsy shows clonal plasma cell infiltration. Imaging (X-ray, CT, MRI, or PET-CT) identifies bone lesions. The International Myeloma Working Group criteria use end-organ damage (the CRAB criteria: hypercalcemia, renal failure, anemia, bone lesions) plus biomarkers to establish a diagnosis and guide treatment.

Treatment depends on patient age and fitness. Induction therapy often combines a proteasome inhibitor, an immunomodulatory drug, and steroids; autologous stem cell transplantation is considered for eligible patients. Monoclonal antibodies (for example, daratumumab) and other targeted therapies have expanded options. Solitary plasmacytoma is typically treated with radiotherapy, with surgery in select cases. Prognosis has improved with newer therapies, but it remains highly variable based on disease biology and response to treatment.