Bone marrow plasmacytosis in multiple myeloma is characteristically more than: September 2011

Ans. C: 30% Manifestations of multiple myeloma includes bone marrow plasmacytosis of more than 30% Multiple myeloma: MC symptomatic monoclonal gammopathy Histology: Russel bodies, flame cells, Mott cells, Dutcher bodies Presents as pathological fractures with hypercalcemia, M-spike and Bence-Jones proteins (light chains) TL-6 is associated with poor prognosis Raised calcium and raised uric acid WHO criteria (major): Bone marrow plasmacytosis more than 30% Plasmacytoma on biopsy Presence of monoclonal M protein (M component) in urine/serum Serum IgG more than 3.5 g/ dl, or Serum IgA more than 2 g/ dl, or Urine Bence-Jones protein more than 1 gm/day WHO criteria (minor): Bone marrow plasmacytosis of 10 - 30% Presence of monoclonal M protein (M component) in urine/ serum, but less than the above concentration Presence of lytic bone lesions Reduced normal immunoglobulins to less than 50% of normal IgG less than 600 mg/ dl, or IgA less than 100 m/ dl, or IgM less than 50 mg/ dl Diagnostic requirement: Minimum of 1 major criterion and 1 minor criterion, or 3 minor criterion which must include bone marrow plasmacytosis of 10 - 30% and the presence of a monoclonal rotein These criteria must be manifested in a symptomatic patient with progressive disease