Multiple myeloma: how did it begin?

OBJECTIVE

To present a historical overview of multiple myeloma.

DESIGN

The pertinent literature, from the early cases of this disorder to subsequent diagnostic advances, was reviewed.

RESULTS

The first well-known case of multiple myeloma (described in the 1840s) was that of Mr. McBean, a highly respectable tradesman from London. Although the features of Bence Jones proteinuria were recognized by his physician, Dr. William Macintyre, urine specimens from Mr. McBean were studied in detail by Henry Bence Jones, a well-known chemical pathologist, who confirmed the findings of Macintyre. The disease was rarely recognized until 1889, when the famous case report by Kahler was published. Interestingly, the subject of this case report (Dr. Loos) survived for 8 years despite inadequate chemotherapy. The role of plasma cells was recognized at the turn of the century. In 1922, Bayne-Jones and Wilson identified two distinct groups of Bence Jones protein, but a relationship between Bence Jones protein and the serum proteins of multiple myeloma was not demonstrated until 1956, in a study performed by Korngold and Lipari. (The designation of the two main classes of Bence Jones protein as kappa and lambda is a tribute to these two investigators.) The major breakthrough was the discovery that light chains from a serum IgG myeloma protein and the Bence Jones protein from the same patient's urine were identical.

CONCLUSION

Multiple myeloma is a devastating disorder of plasma cell proliferation in the bone marrow that can result in skeletal destruction. Immunoelectrophoresis is useful as the initial diagnostic procedure.