Monday, 13 September 2021

Kahler's disease

The disease owes its name to the Austrian doctor Otto Kahler, who described the disease as one of the first. Kahler's disease, also called multiple myeloma, is a disease of the bone marrow caused by an uncontrolled proliferation of a certain type of white blood cells: plasma cells (also called plasmocytes). Plasma cells are responsible for the formation of antibodies under normal conditions.

The bone marrow is a spongy substance located in the interior of bones, especially the pelvis, sternum, ribs and vertebrae. Bone marrow plays a role in forming bones, but also in forming the cells of the blood: white blood cells (leucocytes), red blood cells (erythrocytes) and platelets (thrombocytes). The disease develops in one abnormal plasma cell, which divides uncontrollably and whose offspring also divides uncontrollably. Since they are all related, they only synthesize one specific type of antibody (or part of it). Since antibodies are proteins, the antibody produced is referred to as the "M protein" (from Myeloma protein). The name paraprotein is also commonly used for the M protein. When a specific piece (called “light chain”) of a paraprotein is found in the urine (or blood serum), it is called the Bence-Jones protein.

It is also possible that a plasma cell will proliferates due to cancer, but that no M-protein or Bence-Jones protein is produced at all. Then we speak of a 'non-secreting multiple myeloma'. 

Kahler's disease affects the bones. The malignant plasma cells also produce a substance that breaks down healthy bone tissue. This leads to decalcification in certain places of the skeleton, which makes certain points of the bone very vulnerable. It is therefore easy for fractures to occur in those places.

Because there are so many of them, the plasma cells gradually take the place of the other blood cells that are naturally found in the bone marrow. A lack of healthy plasma cells reduces the production of other antibodies that the body needs for its protection. Due to a lack of red and white blood cells and platelets, the following syndromes can develop:

• anemia

• a higher susceptibility to infections

• a greater risk of bruising

• a longer bleeding time from small wounds

Kahler's disease is a relatively rare form of cancer and affects proportionately more men than women, although this difference has been narrowing for several years.

With thanks to Herbert Spoon, Doctor of Medicine.

Note: the prepared slide, a collectors item, is 60 years old.

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