Haematology & OncologyPending review

Myeloma

A malignant clone of plasma cells expands in the bone marrow and pours out a single monoclonal immunoglobulin, so the clinical picture (bone destruction, renal failure, anaemia and hypercalcaemia) follows directly from marrow infiltration and the toxic paraprotein, summarised as CRAB.

First principles

Myeloma is a clonal expansion of antibody-factory cells, so the disease is defined by what they make as much as by their growth

A single malignant plasma cell clone proliferates in the marrow and secretes one immunoglobulin, or a fragment of one (light chain), in excess: the paraprotein or M-protein. This protein is functionally useless as an antibody but toxic in bulk, while normal polyclonal antibody production from healthy plasma cells is suppressed, which explains the recurrent infections seen in myeloma.

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Educational content pending clinical review. Not medical advice.