Haem: Multiple Myeloma: Free MSRA Podcast

🎙️ Deep Dive: Multiple Myeloma – The Plasma Cell Puzzle Unlocked🧪 High-yield revision for the MSRA and clinical practiceWelcome back to The Deep Dive, where we break down big topics into memorable, exam-focused insights. Today’s topic? Multiple Myeloma – the second most common blood cancer in the UK and a must-know for the MSRA. 🧠In this episode, we’ll walk you through definition, diagnosis, key features, investigations, treatment, and prognosis — all in one concise, efficient session.🧩 What is Multiple Myeloma?• A cancer of plasma cells in bone marrow• Produces abnormal monoclonal proteins (M-protein / paraprotein)• Causes damage to bones, kidneys, immune system, and blood cells• Often preceded by MGUS or Smouldering Myeloma💡 CRAB Features – Core SymptomsUse this in MSRA and clinical diagnosis:C – Calcium (hypercalcaemia → thirst, confusion)R – Renal dysfunction (↑ creatinine, Bence-Jones proteins)A – Anaemia (fatigue, breathlessness)B – Bone lesions (pain, fractures, lytic lesions)🧠 Tip:MGUS → Smouldering Myeloma → Active Myeloma📊 Epidemiology & Risk Factors• Incidence: ~4.5–6 per 100,000/year• Median age: ~72• More common in men and Afro-Caribbean patients• Risk factors: Age, sex, obesity, radiation, benzene, family history🩺 Key Investigations✅ Bloods: FBC, U&Es, calcium, albumin, ESR/CRP✅ Protein tests: • Serum protein electrophoresis (SPEP) • Serum free light chain assay • Urine protein electrophoresis (UPEP) • Immunofixation✅ Bone marrow biopsy → ≥10% clonal plasma cells✅ Imaging: Whole-body MRI or low-dose CT✅ FISH genetic analysis✅ β2-microglobulin & albumin → staging🧬 Diagnosis (IMWG Criteria)→ ≥10% clonal plasma cells OR biopsy-proven plasmacytomaPLUS ≥1 of the following:• CRAB criteria• Plasma cells ≥60%• FLC ratio ≥100• MRI focal lesion ≥1💉 Management EssentialsInduction: Bortezomib + dexamethasone ± immunomodulatorStem cell transplant (if eligible)Maintenance: Lenalidomide (post-transplant)Non-transplant regimens: Thalidomide, Lenalidomide, BortezomibRelapse/refractory: Daratumumab, pomalidomide, 2nd transplant, etc.🛡️ Supportive Care• Bisphosphonates → reduce fractures & calcium• Pain relief → opioids, radiotherapy, nerve meds• Infection prevention → vaccines, IVIG, prophylaxis• Thromboprophylaxis → esp. with lenalidomide• Erythropoietin → anaemia• Spinal stabilisation if needed📉 Complications Recap• Fractures, cord compression• Renal failure• Infections• Anaemia• Hypercalcaemia• AL amyloidosis• Hyperviscosity• Neuropathy📈 Prognosis• Median survival: 2–10+ years• 10-year survival: ~29% in England• Better with early-stage, low-risk genetics, good treatment response• Future outlook improving with CAR-T, bispecifics, and novel therapies📚Multiple MyelomaRevision Resources📝Revision Noteshttps://www.passthemsra.com/topic/multiple-myeloma-revision-notes/🃏Flashcardshttps://www.passthemsra.com/topic/multiple-myeloma-flashcards/📖Accordion Q&ANoteshttps://www.passthemsra.com/topic/multiple-myeloma-accordion-qa-notes/🧠Rapid Quizhttps://www.passthemsra.com/topic/multiple-myeloma-rapid-quiz/https://www.passthemsra.com/quizzes/multiple-myeloma/ 🔑Final Takeaway:Multiple Myeloma = acomplex, multi-systemic cancer of plasma cells. Master CRAB, know the investigations, and understand the evolvingmanagement landscape. Early diagnosis and holistic care are key.For more top-tierrevision materials and mock questions, visit:🌐https://www.passthemsra.com🌐https://www.freemssra.com #MSRA#MultipleMyeloma #MSRARevisionNotes #MSRAFlashcards #MSRAQuestionBank#Haematology #PassTheMSRA #MyelomaCRAB #PlasmaCellCancer #BonePain#RenalFailure #BloodCancer #DeepDivePodcast