Plasma cell dyscrasias
Plasma cell dyscrasia (PCD) is a broad medical term used to describe various hematologic (blood-related) disorders. Plasma cells are produced in bone marrow. If the condition is not accurately diagnosed or if it remains untreated, it can lead to more serious complications and illnesses, such as metabolic disease, certain types of cancer, chronic kidney disease, and diseases that affect the body's autoimmune system.
Definitions & Facts
Plasma cells are responsible for manufacturing antibodies the body needs to defend itself from bacterial infections and viral infections. When these cells begin to grow and multiply in an abnormal manner, the patient is diagnosed with plasma cell dyscrasias.
While medical disorders that affect a person's plasma cells are rare, they are more commonly found in older adults. Plasma cell dyscrasias can include but are not limited to, a diagnosis of multiple myeloma, MGUS (monoclonal gammopathy of undetermined significance), extramedullary plasmacytoma, and Waldenström's macroglobulinemia.
Symptoms & Complaints
- Chronic anemia
- Unexplained bone pain
- Reoccurring, non-resolving infections
- Unusually thick blood
- Formation of blood clots in deeper veins (deep vein thrombosis or DVT)
- Periods of unexplained, extensive bleeding as a result of an injury
- Blood calcium levels higher than 11.5mg/dL
- Kidney failure
- Elevated blood protein levels with no known cause
- Unexplained damage to internal organs
Symptoms and complaints vary according to the specific classification of plasma cell dyscrasia a patient is suspected of having. In some cases, a patient may be asymptomatic, that is, does not experience any obvious symptoms of illness.
Plasma cell dyscrasias result from by the uncontrolled multiplication of a specific type of white blood cells, known as B lymphocytes. Plasma cell dyscrasias are also called plasma cell neoplasms. Neoplasms can either be cancerous or non-cancerous. At the present time, researchers are unclear as to exactly what causes certain plasma cells to begin behaving in an abnormal manner.
Multiple myeloma (a type of blood cancer) has no known risk factors, unlike other types of cancer. While it has not been conclusively proven, it is suspected that there might be a link between certain risk factors (such as age, gender, race, a weakened immune system, or occupational exposure to various environmental toxicants including asbestos, insecticides, petroleum derivatives, et cetera) and the development of certain forms of PCD.
Researchers suspect that genetic factors may play at least a small role in the development of the disease. Genetic mutations may affect oncogenes and tumor suppressor genes in cases of multiple myeloma.
Diagnosis & Tests
When a patient presents with symptoms that suggest a possible diagnosis of plasma cell dyscrasias, there are several testing methods available to assist the physician with making an accurate diagnosis.
- Blood chemistry testing- Blood chemistry testing will check for platelet irregularities, possible electrolyte imbalance, blood viscosity and other indicators.
- Cytogenetic testing. Cytogenetic testing can reveal if there is any evidence of mutations in a person's genetic structure.
- X-rays and/or magnetic resonance imaging (MRI) testing-Both X-rays and an MRI scan can be used to check for any suspected lesions.
- Bone marrow biopsy. Best obtained from either a hip bone or from the breastbone. A bone marrow biopsy allows the physician to better assess a patient's blood plasma cell
- Clinical urine tests. To examine levels of antibodies and protein in a patient's urine.
- A physical examination. A physical exam is conducted for the purpose of assessing the state of a patient's general health. It is also useful for obtaining an accurate history of the patient's past illnesses.
- A bone scan. Also referred to as a skeletal bone survey. This type of scan involves taking X-rays of all of a patient's bones for the purpose of identifying areas of bone damage.
- A complete blood count. This type of test is also called a CBC, with differential. It is used to test for anemia, check a patient's levels of white blood cells, and to establish a patient's platelet count and hemoglobin levels.
Treatment & Therapy
One of the most highly effective treatments for plasma cell dyscrasias is through the use of immunotherapy, as called biotherapy. Immunotherapy involves administering natural or artificial substances, (i.e. antibodies, T-cells, etc.) designed to boost the body's immune system and help it fight infection.
Immunotherapy can be administered either intravenously or in pill form. Intravenous immunotherapy administration is preferred over the pill form, as it bypasses the gastrointestinal tract and delivers the medication directly into the bloodstream without the risk of the stomach destroying the substance being administered.
Depending upon the specific type of plasma cell dyscrasias, the diagnosing physician may choose to treat the patient through additional measures, such as chemotherapy (for multiple myeloma), the use of corticosteroids like prednisone, or the physician may recommend a stem cell transplant.
The exact therapy a physician prescribes to treat a patient diagnosed with PCD will depend on what form of the disease the patient has. The physician will also take into account the overall status of a patient's health, any existing complications, and age when determining which course of treatment to prescribe.
Prevention & Prophylaxis