All information given here is of general nature only, a tumor therapy always belongs in the hands of an experienced oncologist!!! The diagnosis can be difficult to make in some cases. In most cases at the beginning of the disease only an increased blood sedimentation rate (BSG), which is caused by the defective protein proteins, is noticeable.
However, it must be expressly pointed out that most of the increased blood sedimentation rates are due to inflammatory processes. The so-called criteria of salmon and durie are often used to diagnose plasmocytoma multiple myeloma These criteria include the factors listed below:
- The amount of blood pigment (Hb)
- The level of the serum – calcium – content
- The level of protein content
- The number of plasma cells in the bone marrow
- The detection of Bence Jones protein in urine
- The presence of too low amounts of normal defensive proteins.
Multiple myeloma is divided into three stages. The classification depends on the level of paraprotein content, (non-) existing anemia and/or missing platelets, the level of calcium in the blood and the degree of bone damage.
A subdivision into A (well functioning) and B (poor functioning) is made depending on the kidney function. The classification says something about the severity of the disease and the prognosis. In stage IA, therapy can be dispensed with, especially in older people.
This is because treatment is not yet necessary for a given time and waiting until the situation worsens does not harm. The drugs are then saved for the time when they are really needed and the patient is not burdened early on with side effects of the treatment. These recommendations are only general in nature, each therapy must be tailored to the patient.
Stage I: All four criteria must be met. Stage II:Neither stage I nor stage III. Stage III:
- HB > 10 gdl
- Serum – Calcium normal
- X-ray image of normal bone or a maximum of one osteolysis site
- Low paraproteins: – IgG < 5 gdl- IgA< 3 gdl- Light chains in urine < 4 g24 hours
- HB < 8.5 gdl
- Serum – Calcium increased
- More than three osteolysis sites visible in the X-ray image
- High paraproteins: – IgG > 7 gdl- IgA > 5 gdl- light chains in urine > 12 g24 hours
If a change is detectable on an X-ray, the disease is already advanced.
To detect osteolysis at an early stage, magnetic resonance imaging (MRI) can be performed. It also shows early stages of bone changes. Another method of early detection is the skeletal intigraphy.
This method can be used to detect increased bone metabolism even in early stages. In addition to the above-mentioned plasmocytoma criteria according to Salmon and Durie, there are clinically oriented criteria: If two of these criteria apply, a plasmocytoma is considered to be confirmed.
- X-rays of the skeleton to detect osteolysis (bone corrosion). Typical sites are: Thorax (chest), skull, spine, pelvis, shoulders, upper arms and thighs.
- A content of more than 10 % plasma cells in the bone marrow smear or histologically (= fine tissue) detected plasma cell infiltrates
- The detection of monoclonal antibodies, so-called paraproteins in blood or urine
- The detection of osteolysis or general osteoporosis in more than 30% of plasma cells in the bone marrow.
