Multiple myeloma.

The features of multiple myeloma are due to plasma cell proliferation and the production of a monoclonal antibody. Skeletal disease with hypercalcemia, bone marrow dysfunction, sepsis, and renal failure are the commonest problems noted. The diagnosis is suggested by the demonstration of monoclonal gammopathy in the serum or the presence of free immunoglobulin light chains in the urine. Other diagnostic features are bone marrow plasmacytosis, hypogammaglobulinemia and lytic bone lesions. Beneficial responses are seen with supportive care of complications, radiotherapy for severe bone disease and chemotherapy to decrease the tumor burden.