Multiple myeloma presenting with coexisting severe marrow hypoplasia
K Medhi1, Dipti Kalita, Anita Chopra
1Laboratory Oncology Unit, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110 029, India.
Indian Journal of Pathology & Microbiology
|November 15, 2008
Summary
This case highlights a rare coexistence of aplastic bone marrow (BM) and multiple myeloma. Prompt diagnosis using peripheral blood smear and BM touch imprints is crucial for appropriate management.
Area of Science:
- Hematology
- Oncology
Background:
- Aplastic anemia is characterized by bone marrow hypoplasia.
- Multiple myeloma is a plasma cell malignancy.
Observation:
- A 68-year-old man presented with features of aplastic anemia.
- Rouleaux in peripheral blood and 50% plasma cells in bone marrow touch imprints indicated coexisting multiple myeloma.
Findings:
- The coexistence of untreated multiple myeloma and aplastic bone marrow was diagnosed.
- Standard therapy was precluded, and the patient died within 4 days of dexamethasone treatment.
Implications:
- Bone marrow biopsies should be interpreted alongside peripheral blood smears and touch imprints.
- Findings like rouleaux in peripheral blood warrant further investigation beyond apparent aplastic anemia.
- The combination of multiple myeloma and bone marrow aplasia is rapidly fatal and precludes standard treatment.
Related Concept Videos
01:15Differentiation of Common Myeloid Progenitor Cells
Common myeloid progenitors (CMPs) are oligopotent cells that can differentiate into granulocytes and macrophages. Granulocytes and macrophages are essential for protecting the body against bacterial, viral, or fungal infections. They migrate from the bone marrow into the circulating blood to reach specific tissue sites where they differentiate and help in immune surveillance. However, they survive only for a few days and must be continuously made available to the organism to maintain a robust...
01:22Bone Marrow Sampling and Transplants
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:19Multipotency of Hematopoietic Stem Cells
The hematopoietic stem cells or HSCs are multipotent, meaning they can differentiate and give rise to all blood and immune cells. HSCs are maintained in the quiescent stage until an external stimulus initiates their differentiation. The multipotent HSCs exist as two heterogeneous populations, long-term repopulating cells (LTRC) and short-term repopulating cells (STRC). The two HSC populations have different surface markers or receptors and are classified based on quiescence and long-term...