ANEMIA AND MULTIPLE MYELOMA DIAGNOSIS, TREATMENT

The article presents the results of studies of primary patients when contacting a hematologist on the indicators of hemoglobin (Hb) levels in the blood, a high, persistent level of erythrocyte sedimentation rate (ESR), which make it possible to suspect about pre-tumor conditions and the course of multiple myeloma (MM) with the help of additional clinical and laboratory studies, differential diagnostics. The disease with multiple myeloma among the kirghiz population is less common compared to the Russian-speaking population residents of the Kyrgyz Republic (Kirghizia). When comparing the results of studies in first time diagnosed patients with multiple myeloma, anemia was detected in all stages of the disease both among patients of kirghiz nationality and among patients of the Russian-speaking population residents of the Kyrgyz Republic(Kirghizia). Indicators of ESR within the normal levels from 5 to 19 mm/hour in patients of stages I, II and III of multiple myeloma of kirghiz nationality were not detected during our observation. Detection a marker of inflammation, indicators of ESR from 20 to 50 mm/hour among patients of stage I MM of kirghiz nationality in 32% of cases, high persistent ESR levels indicators from 51 to 95 mm/hour among patients in stage III multiple myeloma of kirghiz nationality in 50% of cases, high persistent ESR levels from 51 to 95 mm/hour in 50 % of cases among patients with monoclonal gammapathy of unclear genesis (MGUG) of kirghiz nationality, of smoldering myeloma of kirghiz nationality in 29% of cases. Within the normal range, ESR from 5 to 19 mm/hour are detected in stage I MM of the Russian-speaking population residents of the Kyrgyz Republic (Kirghizia) in 6% of cases, in stage II in 2% of cases and in stage III in 1% of cases. High persistent ESR levels from 51 to 95 mm/hour are detected in patients in 8% of cases with smoldering myeloma of the Russian-speaking population residents of the Kyrgyz Republic(Kirghizia). Important diagnostic criteria for multiple myeloma: In the blood serum monoclonal protein (M-gradient) is detected from 20 to 29 relative% in patients with stage II multiple myeloma of kirghiz nationality in 54% of cases, monoclonal protein (M-gradient) from 30 to 62 rel.% in patients with stage II MM of the Russian-speaking population residents of the Kyrgyz Republic (Kirghizia) in 20% of cases, in stage II multiple myeloma of kirghiz nationality in 4% of cases. In bone marrow punctuate plasma cells from 14 to 29% are more often detected in patients with stage II multiple myeloma of kirghiz nationality in 28% of cases. Plasma cells in bone marrow punctuate from 30 to 86% are detected in patients with stage II MM of the Russian-speaking population residents of the Kyrgyz Republic (Kirghizia) in 27% of cases, stage III MM of kirghiz nationality in 10% of cases. With the right targeted research, all important diagnostic criteria for the diagnosis of multiple myeloma are revealed. Thus, in the initial diagnosis and clinical monitoring, the result of a detailed clinical is important, analysis of the normal hemoglobin(Hb) levels, and high persistent ESR or low levels in hemoglobin(Hb) blood tests, it is necessary to consult a hematologist to find out the source of blood loss leading to various diseases and also detection pre-neoplastic conditions, neoplasms, disease multiple myeloma, which reflect significant features of the course, stages of the disease associated with the activity of the process, progression, complications and unfavorable outcome in the prognosis. Hemoglobin levels indicators play an important role in establishing the stage of the course of multiple myeloma and in most cases the inflammatory marker of ESR increases even before the first signs of the disease appear. Early diagnosis is key value to optimizing effective clinical outcomes. In multiple myeloma anemia has a secondary genesis, affecting the target organs, in connection with which it is necessary to conduct further studies of the kidneys (glomerular filtration rate, creatinine), X-ray of flat bones, total protein and its fractions, the presence of pathological protein, bone marrow study. According to clinical and special laboratory diagnostic tests, early timely diagnosis of pre-neoplastic previous myeloma conditions (monoclonal gammapathy of unclear genesis (MGUG), asymptomatic or smoldering myeloma) and multiple myeloma with manifestations of anemia, with a persistent, high level of ESR makes it possible to prescribe standard chemotherapy in a timely manner to improve survival and quailty of life for patients.