Stem cells can develop into many cell types and act as the body’s repair system. They replace or restore damaged tissues, offering new possibilities for treating diseases.
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Diagnosing multiple myeloma requires a detective-like approach that combines biochemical analysis, advanced imaging, and direct tissue sampling. The evaluation is designed not only to confirm the presence of malignant plasma cells but also to determine the total burden of the disease (staging) and its specific biological aggression (risk stratification). This comprehensive workup is essential for planning a treatment strategy that may include complex procedures like stem cell transplantation.
The initial suspicion of myeloma is often confirmed by blood and urine tests that detect the abnormal M-protein.
The definitive diagnosis of multiple myeloma resides in the bone marrow. A bone marrow aspiration and biopsy are performed to visualize and quantify the plasma cells.
Perhaps the most critical component of the modern evaluation is the genetic analysis of the myeloma cells. Because myeloma is highly heterogeneous, understanding the specific genetic mutations that drive prognosis and treatment choice is essential.
Modern imaging has moved beyond simple X-rays to more sensitive modalities that can detect bone disease before a fracture occurs.
Once all data is gathered, the patient is staged using the Revised International Staging System (R-ISS). This system combines three elements to categorize the patient into Stage I, II, or III:
LDH Levels: Lactate Dehydrogenase, an enzyme that, when elevated, indicates rapid cell turnover and aggressive disease.
Before any treatment begins, specifically stem cell transplantation, a thorough physiological evaluation is conducted.
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The procedure is performed with local anesthesia to numb the skin and the surface of the bone (periosteum). Patients may feel pressure and a brief, sharp sensation during marrow aspiration. Sedation is often available to ensure the patient remains comfortable and relaxed during the procedure.
X-rays (skeletal surveys) only show significant bone damage that has already occurred (like holes in the bone). A PET scan detects the metabolic activity of the cancer cells. This means a PET scan can find active myeloma lesions before they have destroyed enough bone to be seen on an X-ray, allowing for earlier treatment.
The genetic profile (FISH results) indicates how aggressive the myeloma is likely to be. It helps separate “standard risk” patients from “high risk” patients. This information is used to tailor the intensity of the treatment plan, such as choosing specific drugs or deciding on the necessity of a stem cell transplant.
A plasmacytoma is a discrete, solid tumor made of plasma cells. It can occur within the bone (solitary bone plasmacytoma) or in soft tissues (extramedullary plasmacytoma), such as the throat or sinuses. While it is made of the same cells as multiple myeloma, it is a localized mass rather than a systemic marrow disease.
Imaging is typically performed at diagnosis to set a baseline. It may be repeated if the patient experiences new bone pain or symptoms suggesting relapse. PET/CT scans are also sometimes used after treatment to confirm remission and ensure there is no active disease remaining in the body.
stem cell transplant for multiple myeloma Recent studies show that life expectancy after a stem cell transplant varies. This depends on the type of cancer
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