Paraproteinemia and multiple myeloma

This condition is treated in the Haematology (including oncological disorders) clinic.

Pre-referral work-up

History

The diagnosis of multiple myeloma requires the presence of a malignant plasma cell population (evidenced on bone marrow biopsy or plasmacytoma) AND demonstrable end-organ dysfunction

All referrals should comply to referral standards referral standards and include in particular:

• Relevant investigations, including previous results to assess temporal pattern
• Evidence of end-organ damage

Tests

• Calcium
• Renal function
• FBE
• Xray of areas of suspicion
• Consider bone scan

Interim/GP management

To refer a patient with this condition, please see the Haematology clinic page for the full referral process and templates.

In the presence of a paraprotein, assessment for end-organ dysfunction (CRAB - see below) is critical in the diagnostic algorithm, and the following assessments should be enclosed:

• C - Hypercalcaemia
• R - Renal impairment (without other cause)
• A - Anaemia/other cytopenia (without other cause)
• B - Bone lesions (lytic lesions, pathological fracture, unexplained osteoporosis)

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Suspected spinal cord compression (pain and neurological symptoms) in a patient with known or suspected multiple myeloma.

? Impending pathological fracture (radiologically identified) in a patient with known or suspected Multiple Myeloma

? Significant hypercalcaemia over 2.9 mmol/L

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Availability

North

Launceston General Hospital
Level 1 - W.P. Holman Clinic
Phone: 03 6777 6140
Fax: 03 6331 6371

North West

North West Regional Hospital > Mersey Community Hospital
Torquay Road Latrobe TAS 7307

Visit Northern Cancer Service

South

Royal Hobart Hospital (Level 1 - A Block)

Phone (appointments): 03 6166 6655
Phone (clinic nurses): 03 6166 6637
Fax: 03 6173 0484