Abstract

1. Multiple myeloma is an uncommon but uniquely important disease, and it is encountered with increasing frequency. 2. Clinically, the occurrence of pain, especially in the back, unexplained anemia or proteinuria in older people should arouse suspicion of multiple myeloma. The diagnostic importance of bone changes by x-ray, of marrow aspiration and of use of paper electrophoresis of the serum and urine has been stressed. 3. The treatment of myeloma, in common with that of most neoplastic disorders, is unsatisfactory. However, some patients obtain remissions on urethan, and painful bone lesions are greatly improved by local x-ray therapy. 4. The abnormal protein metabolism in myeloma is a fascinating aspect of this disease and presents fundamental problems concerning the synthesis of globulins in plasma cell dyscrasias. The role of these proteins in the pathogenesis of renal damage and para-amyloidosis has been discussed in the light of newly acquired immunologic and physicochemical knowledge.

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