ABSTRACT
Multiple myeloma (MM) is characterized by malignant plasma cells infiltrating the bone marrow and, in some patients, other organs and extramedullary tissues. In most cases, monoclonal immunoglobulin molecules or immunoglobulin light chains can be measured in the serum or urine and used as a specific marker for diagnosis and follow up (Table 7.1). Presenting symptoms depend on tumor burden and individual complications induced by each myeloma plasma cell clone. The clone may produce and secrete monoclonal immunoglobulin, different cytokines, and less defined biological and physically active
factors, which interfere with bone metabolism, renal function, hematopoiesis, immune mechanisms, and other organ systems. Different patterns of such complications contribute to the heterogeneity of MM patients in terms of symptoms, treatment strategy, and prognosis. This chapter will present an overview of the clinical features of myeloma. Particular complications are dicussed in more detail in subsequent chapters.
