Lumbar myeloma

Tumors are prone to grow in many parts of the human body, and myeloma is also prone to grow in the bone marrow in the human bones. The lumbar vertebra is a very large joint organ in the body. Together with the cervical vertebrae, thoracic vertebrae and coccygeal vertebrae, it forms the human spine. Lumbar myeloma can also occur in the lumbar spine, and the condition of this disease is very complicated. How should lumbar myeloma be treated?

Myeloma (MM) is a malignant plasma cell disease, which can be divided into single and multiple myeloma. Its tumor cells originate from plasma cells in the bone marrow, which are cells that develop from B lymphocytes to the final functional stage. Therefore, multiple myeloma can be classified as a B-lymphocytic lymphoma. Currently, WHO classifies it as a type of B-cell lymphoma, called plasma cell myeloma or plasmacytoma. It is characterized by abnormal proliferation of bone marrow plasma cells accompanied by excessive production of monoclonal immunoglobulins or light chains (M proteins). A very small number of patients may have non-secretory MM that does not produce M protein. Multiple myeloma is relatively common and is often accompanied by complications such as multiple osteolytic lesions, hypercalcemia, anemia, and kidney damage. Since the production of normal immunoglobulins is suppressed, various bacterial infections are prone to occur. The incidence rate is estimated to be 2 to 3/100,000, with a male to female ratio of approximately 2:1, and most patients are over 40 years old.

Myeloma is a progressive neoplastic disease characterized by excessive proliferation of bone marrow plasma cells and an intact monoclonal immunoglobulin (IgG, IgA, IgD or IgE) or Bence Jones protein (free monoclonal kappa or gamma light chain). Multiple myeloma is often accompanied by multiple osteolytic lesions, hypercalcemia, anemia, kidney damage, increased susceptibility to bacterial infections, and suppressed production of normal immunoglobulins. The incidence rate is estimated to be 2-3/100,000, with a male-to-female ratio of 1.6:1, and most patients are >40 years old. The incidence of black patients is twice that of white patients. The cause of myeloma is unknown. However, the herpes virus associated with Kaposi's sarcoma was found in the dendritic cells cultured from myeloma patients, suggesting that there is a certain connection between the two. The virus encodes a homolog of interleukin-6 (IL-6). Human IL-6 can promote myeloma growth and stimulate bone resorption. The origin of this special cell type is still unclear, but analysis of immunoglobulin gene sequences and cell surface markers suggests that it is derived from malignant transformation of post-germinal center cells.

Possible causes include ionizing radiation, exposure to industrial or agricultural toxins, chronic infection, chronic antigen stimulation, genetics, and cytokines such as IL-6. The incidence and mortality of myeloma have increased among survivors of the atomic bomb explosion in Japan. This disease can occur on the basis of chronic osteomyelitis, pyelonephritis, tuberculosis, chronic hepatitis, and autoimmune diseases, because long-term chronic infection can manifest as lymphoreticular hyperplasia, autoimmune reaction and hypergammaglobulinemia.

Treatment

(I) Chemotherapy generally adopts various combined chemotherapy schemes, and patients with initial treatment can choose various schemes; after complete remission is achieved through chemotherapy, VCAP and MEPP schemes are used.

(II) Symptomatic treatment

1. If you are infected with bacteria, antibiotics should be used.

2. For hypercalcemia, increase the amount of fluid replacement and drink more water to make the urine volume >2000ml per day to promote calcium excretion.

3. For hyperuricemia, give large amounts of fluids, take sodium bicarbonate orally or intravenously, and give allorinol 100 ml/time.

4. Androgens can be used to treat anemia.

5. Renal failure.

(III) Radiotherapy can make the tumor disappear and relieve local pain. Irradiation of 200-300cGy can alleviate bone pain.

(IV) Interferon: High doses of α-interferon can inhibit the proliferation of myeloid cell tumors. The clinical application of interferon combined with chemotherapy to treat this disease can improve the complete remission rate of chemotherapy. Usage: (3-5)×10,6 units subcutaneous injection, 3 times a week, for 4-6 weeks.