immunoelectrophoresis

Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of your immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bones.

No one knows the exact causes of multiple myeloma, but it is more common in older people and African Americans. It can run in families. Common symptoms may include:

• Bone pain, often in the back or ribs
• Fractures (broken bones)
• Weakness or fatigue
• Weight loss
• Frequent infections and fevers
• Feeling very thirsty
• Frequent urination

Doctors diagnose multiple myeloma using lab tests, imaging tests, and a bone marrow biopsy. Your treatment depends on how advanced the disease is and whether you have symptoms. If you have no symptoms, you may not need treatment right away. If you have symptoms, you may have chemotherapy, stem cell transplantation, radiation, or targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Leukemia is a term for cancers of the blood cells. Leukemia starts in blood-forming tissues such as the bone marrow. Your bone marrow makes the cells which will develop into white blood cells, red blood cells, and platelets. Each type of cell has a different job:

• White blood cells help your body fight infection
• Red blood cells deliver oxygen from your lungs to your tissues and organs
• Platelets help form clots to stop bleeding

When you have leukemia, your bone marrow makes large numbers of abnormal cells. This problem most often happens with white blood cells. These abnormal cells build up in your bone marrow and blood. They crowd out the healthy blood cells and make it hard for your cells and blood to do their work.

Chronic lymphocytic leukemia (CLL) is a type of chronic leukemia. "Chronic" means that the leukemia usually gets worse slowly. In CLL, the bone marrow makes abnormal lymphocytes (a type of white blood cell). When the abnormal cells crowd out the healthy cells, it can lead to infection, anemia, and easy bleeding. The abnormal cells can also spread outside the blood to other parts of the body. CLL is one of the most common types of leukemia in adults. It often occurs during or after middle age. It is rare in children.

CLL happens when there are changes in the genetic material (DNA) in bone marrow cells. The cause of these genetic changes is unknown, so it's hard to predict who might get CLL. There are a few factors that might raise your risk.

It is hard to predict who will get CLL. There are a few factors that could raise your risk:

• Age - your risk goes up as you get older. Most people who are diagnosed with CLL are over 50.
• Family history of CLL and other blood and bone marrow diseases
• Racial/ethnic group - CLL is more common in whites than in people from other racial or ethnic groups
• Exposure to certain chemicals, including Agent Orange, a chemical that was used in the Vietnam War

In the beginning, CLL does not cause any symptoms. Later, you can have symptoms such as:

• Swollen lymph nodes - you may notice them as painless lumps in the neck, underarm, stomach, or groin
• Weakness or feeling tired
• Pain or a feeling of fullness below the ribs
• Fever and infection
• Easy bruising or bleeding
• Petechiae, which are tiny red dots under the skin. They are caused by bleeding.
• Weight loss for no known reason
• Drenching night sweats

Your health care provider may use many tools to diagnose CLL:

• A physical exam
• A medical history
• Blood tests, such as a complete blood count (CBC) with differential and blood chemistry tests. Blood chemistry tests measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), kidney function tests, liver function tests, and an electrolyte panel.
• Flow cytometry tests, which check for leukemia cells and identify which type of leukemia it is. The tests can be done on blood, bone marrow, or other tissue.
• Genetic tests to look for gene and chromosome changes

If you are diagnosed with CLL, you may have additional tests to see whether the cancer has spread. These include imaging tests and bone marrow tests.

Treatments for CLL include:

• Watchful waiting, which means that you don't get treatment right away. Your health care provider regularly checks to see if your signs or symptoms appear or change.
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells.
• Chemotherapy
• Radiation therapy
• Immunotherapy
• Chemotherapy with bone marrow or stem cell transplant

The goals of treatment are to slow the growth of the leukemia cells and to give you long periods of remission. Remission means that the signs and symptoms of cancer are reduced or have disappeared. The CLL may come back after remission, and you may need more treatment.

NIH: National Cancer Institute

Your immune system is a complex network of cells, tissues, and organs. Together they help the body fight infections and other diseases.

When germs such as bacteria or viruses invade your body, they attack and multiply. This is called an infection. The infection causes the disease that makes you sick. Your immune system protects you from the disease by fighting off the germs.

The immune system has many different parts, including:

• Your skin, which can help prevent germs from getting into the body
• Mucous membranes, which are the moist, inner linings of some organs and body cavities. They make mucus and other substances which can trap and fight germs.
• White blood cells, which fight germs
• Organs and tissues of the lymph system, such as the thymus, spleen, tonsils, lymph nodes, lymph vessels, and bone marrow. They produce, store, and carry white blood cells.

Your immune system defends your body against substances it sees as harmful or foreign. These substances are called antigens. They may be germs such as bacteria and viruses. They might be chemicals or toxins. They could also be cells that are damaged from things like cancer or sunburn.

When your immune system recognizes an antigen, it attacks it. This is called an immune response. Part of this response is to make antibodies. Antibodies are proteins that work to attack, weaken, and destroy antigens. Your body also makes other cells to fight the antigen.

Afterwards, your immune system remembers the antigen. If it sees the antigen again, it can recognize it. It will quickly send out the right antibodies, so in most cases, you don't get sick. This protection against a certain disease is called immunity.

There are three different types of immunity:

• Innate immunity is the protection that you are born with. It is your body's first line of defense. It includes barriers such as the skin and mucous membranes. They keep harmful substances from entering the body. It also includes some cells and chemicals which can attack foreign substances.
• Active immunity, also called adaptive immunity, develops when you are infected with or vaccinated against a foreign substance. Active immunity is usually long-lasting. For many diseases, it can last your entire life.
• Passive immunity happens when you receive antibodies to a disease instead of making them through your own immune system. For example, newborn babies have antibodies from their mothers. People can also get passive immunity through blood products that contain antibodies. This kind of immunity gives you protection right away. But it only lasts a few weeks or months.

Sometimes a person may have an immune response even though there is no real threat. This can lead to problems such as allergies, asthma, and autoimmune diseases. If you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake.

Other immune system problems happen when your immune system does not work correctly. These problems include immunodeficiency diseases. If you have an immunodeficiency disease, you get sick more often. Your infections may last longer and can be more serious and harder to treat. They are often genetic disorders.

There are other diseases that can affect your immune system. For example, HIV is a virus that harms your immune system by destroying your white blood cells. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). People with AIDS have badly damaged immune systems. They get an increasing number of severe illnesses.

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.

Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors - diabetes, high blood pressure, heart disease, or a family history of kidney failure.

Specific kidney tests include:

• Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
• Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
• Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
• Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
• Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases