Multiple myeloma in children is a malignant plasma cell disease. The tumor cells originate from the plasma cells in the bone marrow, and the plasma cells are the cells in the final functional stage of B lymphocytes. Therefore, multiple myeloma can be classified as B-lymphocyte lymphoma. The incidence of the disease is estimated to be 2-3/100000, and the ratio of male to female is 1.6:1. Although rare, parents also need to be vigilant.
Multiple myeloma in children has a slow onset, no obvious symptoms in the early stage, and is easy to be misdiagnosed, but it has its main clinical manifestations.
Bone pain Myeloma cells secrete osteoclast active factors and activate osteoclasts to dissolve and destroy bone. Bone pain is the most common symptom, mostly lumbosacral, sternal and rib pain. Because tumor cells destroy the bone and cause pathological fractures, multiple fractures can exist at the same time.
Anemia is common, which is the first symptom. Anemia is mild in the early stage and severe in the late stage. In the late stage, thrombocytopenia may occur, causing bleeding symptoms. Skin and mucosa hemorrhage is more common, and visceral and intracranial hemorrhage can be seen in severe cases.
Extramedullary plasmacytoma or amyloidosis should be considered for enlargement of liver and spleen, enlargement of cervical lymph nodes, myeloma, enlargement of renal organs or abnormal tumors.
Fungal and viral infections are most commonly bacterial pneumonia, urinary tract infection, septicemia, and viral herpes zoster is also prone to occur, especially in patients with low immunity after treatment.
In addition, extramedullary plasmacytoma of the nervous system can cause limb paralysis, lethargy, coma, diplopia, blindness, and vision loss.
In case of one or more of the above clinical symptoms, we should be highly alert. These body danger signals indicate multiple myeloma, and we should take the child to the hematology department in time.
Deng Ying, Hematology Department, Hunan Children's Hospital
