الفهرس 
Multiple Myeloma
Diagnostic criteria for MM:Only 14 pages are availabe for public view
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Abstract
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow producing excessive amount of monoclonal immunoglobulins (Ig) and suppression of other normal polyclonal immunoglobulins, leading to bone destruction and marrow failure. The pathogenesis of MM is heterogenous, it is characterised by complex cytogenetic abnormalities together with microenvironmental changes in which many cytokines and growth factors play an important role. Tumor necrosis factor is one of these cytokines which promotes the growth and survival of myeloma cells. Tumor necrosis factor receptor superfamily member 17 also designated as B-cell maturation antigen (BCMA) or CD256 is a receptor which is shown to be expressed on B lymphocytes as they mature. It is nearly absent on naïve and memory B cells. BCMA is known to bind to B cell activating factor (BAFF) or A proliferation inducing ligand (APRIL), leading to activation of cell proliferation pathways and upregulation of antiapoptotic proteins which is considered the main step in pathogenesis of MM. Aim of the work: This study aimed to evaluate serum BCMA level in multiple myeloma patients and its clinical significance. This prospective study was conducted in Clinical Pathology Department, Faculty of Medicine, Tanta University. Patients with MM from Hematology Unite, Internal Medicine Department, and Oncology Department, Faculty of Medicine, Tanta University. Subjects were classified into two groups including group I (MM patients) which was 40 patients newly diagnosed as MM and group II (healthy Control) which was 40 apparently healthy individuals served as control. Both patients and control groups were subjected to the following: • History taking, clinical examination, clinical parameters as age and sex. • Routine laboratory investigations including complete blood picture, renal function tests, ESR. • Serum LDH level. • Serum total calcium level. • Beta-2-microglobulin assay. • Bone marrow aspiration and protein electrophoresis (only patients). • Serum BCMA level. The results of this study revealed that, there was statistically significant decrease in MM patients than control group in hemoglobin and platelet count. While as regard serum creatinine level, Beta-2- microglobulin, serum calcium level, ESR and LDH, there was statistically significant increase in MM patients than control group. As regard M protein, M band was IgG in 37 cases with a percentage of (92.5%) and IgA in 3 cases with a percentage of (7.5%) . Gamma globulin levels were increased in MM patients. Plasma cell percentage in BM aspiration was statistically significant increased in MM patients. Number of bone lesions was statistically significant increased in MM patients . Nearly all MM patients were complaining of one or more bone lesions. There was a significantly positive correlation between BCMA level and plasma cell in BM, M protein, number of bone lesions and serum Beta-2- microglobulin. There was no correlation between BCMA level and age, hemoglobin and creatinine. Serum BCMA level had 95% sensitivity, 80% specificity 83% and positive predictive value (PPV) and 94% negative predictive value (NPV).