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DEFINITION MULTIPLE MYELOMA MULTIPLE MYELOMA • It is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance (MGUS) to plasma cell leukemia. • It is characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein. • The antibody-forming cells (i.e., plasma cells) are malignant and, therefore, may cause unusual manifestations. Retrieved from: http://emedicine.medscape.com/article/204369-overview Bone marrow aspirate demonstrating plasma cells of multiple myeloma. Note the blue cytoplasm, eccentric nucleus, and perinuclear pale zone (or halo). All images and text are (c) 2002 by the American Society of Hematology. All rights reserved. Bone marrow biopsy demonstrating sheets of malignant plasma cells in multiple myeloma. All images and text are (c) 2002 by the American Society of Hematology. All rights reserved. MULTIPLE MYELOMA • represents a malignant proliferation of plasma cells derived from a single clone • The tumor, its products, and the host response to it result in: – – – – – – – – – multiple organ dysfunctions, symptoms of bone pain or fracture, renal failure, susceptibility to infection, anemia, neurologic symptoms, hypercalcemia, occasionally clotting abnormalities, and vascular manifestations of hyperviscosity Braunwald et al, Harrison’s Principles of Internal Medicine, p 701