ABSTRACT
Multiple myeloma (MM) is a malignant disease of plasma cells in the bone marrow and forms part of a spectrum of plasma cell disorders that also includes monoclonal gammopathy of undetermined significance (MGUS), solitary plasmacytoma and primary amyloidosis. MM has an annual incidence of approximately 50 per million and a median age at presentation of approximately 70 years in the United Kingdom and North America. MM is thought to arise typically on a background of previous MGUS, a pre-malignant condition. In at least half of MGUS patients, clonal plasma cell proliferation is thought to be initiated by primary translocations involving the immunoglobulin heavy chain locus on chromosome 14q32 and a promiscuous range of partner chromosomes. Immune dysfunction is an important feature of MM and infection remains a major cause of morbidity and mortality with approximately 10% of the patients dying in the first 60 days, many from infection.
