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Boston –17th International Multiple Myeloma Workshop September 12-15, 2019
NON-SECRETORY MULTIPLE MYELOMA, A RARE HEMATOLOGIC ENTITY AND POSSIBLE MISDIAGNOSIS: A CASE REPORT WARNING.
At the 17th International Workshop on Multiple Myeloma, Malignant Hematological Disease, second in incidence in the United States, the Ruesch Clinic will be represented by Prof Antonio Abbadessa, an oncologist who has been active for years in the facility, who will discuss a case with clinical-laboratory traits are completely unusual.
Multiple myeloma is a neoplastic disease of plasma cells, cells of the bone marrow, whose neoplastic transformation, for causes still unknown today, results in their uncontrolled proliferation with secretion of aberrant immunoglobulins, which in the rutinary laboratory screenings are revealed by the presence of a peak in the protein framework.
The disease, sometimes dormant for a long time, involves sometimes severe cytopenias, such as anemia, decrease of white blood cells and platelets, osteolithic lesions with bone pain and pathological fractures, severe kidney damage up to dialysis, peripheral neuropathies.
In rare cases, and the one questioned by Prof Abbadessa is one of them, tumor plasma cells do not produce immunoglobuline, but only small amounts of parts of them: in such cases the disease remains "invisible" to routine investigations.
The novelty is that, for some years now, a well-standardized test has been available in the laboratory that allows with a simple blood sample to identify in the serum such fragments, called free light chains (Free Light Chain) and early unravel the disease before damage, especially at the bone level (pain and fractures) and at the kidney level (insufficiency).
Unfortunately, this test has not yet entered the current practice, resulting in a delay in diagnosis and therapy, as happened in the case study; Early diagnosis, on the other hand, would be valuable since in the last ten years innovative therapies have been made available capable of controlling the disease effectively.
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