White blood cells, or leukocytes are cells of the immune system involved in defending the body against both

infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. The number of leukocytes in the blood is often an indicator of disease. There are normally between 4109 and 1.11010 white blood cells in a litre of blood

Classification Of WBCs Disorders

WBC Disorders

Leukocytosis

Leukopenia

Definition: number of white cells in the blood

Leukocytosis is a condition characterized by an elevated

Neutrophillic Lymphocytosis Monocytosis Eosinophilla Basophillia

Definition:

An abnormal decrease in the number of white blood cells to

fewer than 5000 cells per cubic millimeter. The condition may be caused by an adverse drug reaction, radiation poisoning,

or pathologic conditions. One or all kinds of white blood cells

may be affected. The two most common forms of leukopenia are .

Neutropenia Lymphopenia

Leukemia:
Definition:

A progressive, malignant disease of the

blood-forming organs, marked by distorted proliferation and development of leukocytes and their precursors in the blood and bone marrow.
Acute ( Myeloid / Lymphoid ) Chronic ( Myeloid / Lymphoid )

Myeloma

A cancer of plasma cells, a type of white blood cell normally responsible for the production of antibodies. Collections of abnormal cells accumulate in bones, where they cause bone lesions (abnormal areas of tissue), and in the bone marrow where they interfere with the production of normal blood cells.

DEFINITION:

RISK FACTORS
Age

Race Gender Family

history MGUS

Monoclonal Gammopathy of Undetermined Significances, is a benign condition in which abnormal plasma cells make M proteins. Usually, there are no symptoms, and the abnormal level of M protein. M protein is a Virulence of bacterium Streptococcus pyogenes. It is an abnormal protein in blood or urine, often seen in MGUS.

CAUSES:
Although the exact cause isn't known, doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow, the soft, bloodproducing tissue that fills in the center of most of your bones. This abnormal cell then starts to multiply.

The genetic abnormalities associated with multiple myeloma include: A defect related to chromosome 14 in which a piece of one chromosome moves to a different chromosome (translocation) Extra copies of certain chromosomes (hyperdiploidy) An abnormality in which part or all of chromosome 13 is missing

Bone pain usually in back and ribs Broken bones Feeling weak and tired Feeling thirsty Frequent urination Frequent infections and fever Weight loss Abnormal bruising and bleeding.

Doctors sometimes find multiple myeloma after a routine blood test. More often, doctors suspect multiple myeloma after an x-ray for a broken bone. Usually though, patients go to the doctor because they are having other symptoms.

Blood tests: Multiple myeloma causes high levels of proteins in the blood. The lab checks the levels of many different proteins, including M protein and other immunoglobulins (antibodies), albumin, and beta-2-microglobulin. Myeloma may also cause anemia and low levels of white blood cells and platelets. The lab does a complete blood count to check the number of white blood cells, red blood cells, and platelets.

The lab also checks for high levels of calcium. To see how well the kidneys are working, the lab tests for creatinine.

The lab checks for Bence Jones protein in urine.The lab measures the amount of Bence Jones protein in urine collected over a 24-hour period.

X- RAYS:
X-rays to check for broken or thinning bones. An x-ray of your whole body can be done to see how many bones could be damaged by the myeloma.

A biopsy is the only sure way to know whether myeloma cells are in bone marrow.

International Staging System Stage I: 2-microglobulin (2M) <3.5 mg/L, albumin >= 3.5 g/dL Stage II: 2M < 3.5 mg/L and albumin < 3.5 g/dL; or 2M 3.5 mg/L - 5.5 mg/L irrespective of the serum albumin Stage III: 2M >= 5.5 mg/L

Durie-Salmon staging system stage I: all of Hb > 10g/dL normal calcium Skeletal survey: normal or single plasmacytoma or osteoporosis Serum paraprotein level < 5 g/dL if IgG, < 3 g/dL if IgA Urinary light chain excretion < 4 g/24h Stage II: fulfilling the criteria of neither I nor III

stage III: one or more of Hb < 8.5g/dL high calcium > 12 mg/dL Skeletal survey: Three or more lytic bone lesions Serum paraprotein > 7g/dL if IgG, > 5 g/dL if IgA Urinary light chain excretion > 12g/24h

Stages I, II, and III of the Durie-Salmon staging system can be divided into A or B depending on serum creatinine:
A: serum creatinine < 2 mg/dL (< 177 umol/L) B: serum creatinine > 2 mg/dL (> 177 umol/L)

People with multiple myeloma have many treatment options. The options are watchful waiting,radiation therapy, induction therapy, and stem cell transplant.

People with smoldering myeloma or Stage I myeloma. Regular checkups (such as every 3 months) Receive treatment if symptoms occur.

In radiation therapy (also called radiotherapy), high-energy rays are used to damage cancer cells and stop them from growing and dividing.

1)

2)

3)

Chemotherapy: Chemotherapy kills fastgrowing myeloma cells, but the drug can also harm normal cells that divide rapidly. Immunotherapy:This treatment stimulates the immune system to fight multiple myeloma. The two main drugs used are Thalomid(thalidomide) and Revlimid(lenalidomide). They help keep multiple myeloma cells from reproducing within bone marrow. Steroids: Some steroids have antitumor effects. It is thought that steroids can trigger the death of myeloma cells. A steroid may be used alone or with other drugs to treat myeloma.

Blood cells Hair loss Poor appetite Nausea Vomiting Diarrhea Constipation Mouth and lip sores Dizziness Drowsiness Tingling in hands or feet Low blood pressure

1. 2. 3.

Autologous stem cell transplant From a family member or other donor From your identical twin

Thank you for your time

Any Questions