Multiple myeloma and other plasma cell diseases

master's thesis

• Title (croatian): Multipli mijelom i druge bolesti plazma stanica
• Author: Dor Yehezkel Moritz
• Mentor: Dražen Pulanić (mentor)
• Committee member: Dražen Pulanić (predsjednik povjerenstva)
• Committee member: Nadira Duraković (član povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

This graduate thesis reviews multiple myeloma (MM), a malignant disease of plasma cells. It accounts for 1% of all cancers and is the 2nd most common hematologic malignancy after lymphoma. It is considered a disease of the elderly, with a median age of 66-70 year at diagnosis. Monoclonal gammopathy of undetermined significance (MGUS) is premalignant condition of MM followed by smoldering multiple myeloma (SMM) and finally symptomatic MM. To differentiate the 3 conditions, the international myeloma working group has set criteria that can differentiate MGUS, SMM and MM. Symptomatic MM is characterized by the end organ damage described by the acronym CRAB, that is, hypercalcemia, renal insufficiency, anemia and bone lesions. Beside CRAB symptoms, MM patients also suffer from infections, possible thrombosis and bleeding, all described in this graduate thesis. MM therapy has tremendously progressed over the past decades since introduction of autologous stem cell transplantation (ASCT) and resulted in achieving deeper remission and prolonging the life span of MM patients. Multiple protocols exist regarding combinations of medications and nowadays they largely include a triple therapy with a proteasome inhibitor, immunomodulatory drug and a corticosteroid.

Abstract (croatian)

Ovaj diplomski rad obrađuje multipli mijelom (MM), zloćudnu bolest plazma stanica. Mijelom čini 1% svih vrsta zloćudnih bolesti i druga je najčešća hematološka zloćudna bolest nakon limfoma. Smatra se bolešću starijih osoba, koja je dijagnosticirana s medijanom dobi od 66 do 70 godina. Monoklonalna gamapatija neutvrđenog značenja (engleski MGUS, Monoclonal Gammapathy of Undetermined Significance) je premaligno stanje nakon čega slijedi asimptomatski („šuljajući“, engleski „smoldering“) mijelom (SMM) i konačno simptomatski MM. Da bi se razlikovala navedena tri stanja, međunarodna radna skupina za mijelom postavila je kriterije koji mogu razlikovati MGUS, SMM i MM. Simptomatski MM karakterizira oštećenje ciljih organa koje uzrokuje hiperkalcijemiju, bubrežnu insuficijenciju, anemiju i koštanu leziju (CRAB simptome). Osim symptom CRAB-a, bolesnici s MM-om također mogu imati infekcije, tromboze i krvarenja, što je također opisano u ovom diplomskom radu. Liječenje MM-a je u posljednjih nekoliko desetljeća izuzetno napredovalo uvođenjem autologne transplantacije matičnih krvotvornih stanica i rezultiralo je postizanjem duboke remisije I produljenjem životnog vijeka oboljelih od MM-a. Postoje brojni protokoli za liječenje MM-a koji danas uglavnom uključuju trostruku terapiju s inhibitorom proteasoma, imunomodulatornim lijekom i kortikosteroidom.

• Keywords: multiple myeloma; monoclonal gammopathy of undetermined significance; CRAB; autologous stem cell transplantation
• Keywords (croatian): multipli mijelom; monoklonalna gamapatija neodređenog značenja; CRAB; autologna transplantacija matičnih krvotvornih stanica
• Language: english
• URN:NBN: urn:nbn:hr:105:328299
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-07-20 08:39:55