全英多发性骨髓.pptxVIP

Multiple Myeloma（MM ，多发性骨髓瘤 ）;Definition What is Multiple Myeloma? ;;Clinical features: Related Organ or Tissue Impairment, ROTI  相关器官或组织损害;;Typical skeletal changes on roentgenogram. (a) Example of “punched-out” lytic lesions in skull. (b) Diffuse osteopenia with compression fractures of spine. (c) Lytic lesions in the left humerus.;;;;Monoclonal globulin;Gel electrophoresis of proteins;Symptomatic myeloma: 1.Clonal plasma cells 10% on bone marrow biopsy or (in any quantity) in a biopsy from other tissues ，Hypercalcemia (plasmacytoma) 。 2.A monoclonal protein (paraprotein) in either serum or urine (except in cases of true non-secretory myeloma) 3.Evidence of end-organ damage felt related to the plasma cell disorder (related organ or tissue impairment, ROTI, commonly referred to by the acronym CRAB): C: Calcium elevation ( 11.5 mg/L or ULN) R: Renal dysfunction (serum creatinine 2 mg/dL) A: Anemia (Hb 10 g/dL or 2 g normal) B: Bone disease (lytic lesions or osteoporosis);;International Staging System;;;;;;Chromosomal Abnormality ;Multiple Myeloma FISH panel includes:;;欧洲骨髓瘤网络：多参数流式细胞检测(MFC);the conventional radiography of the pelvis (A) showed no osteolysis, while there were several foci on STIR-weighted;;Mehta, J. et al. Blood 2010;116:2215-2223;mSMART: classification of active multiple myeloma (MM);mSMART危险度分层的衍变;AlloSCT in;Treatment;Case-1 (M/77岁);Case-1;Case-1;Case-1;Case-2 (M/62岁);;;Case-2;;;;