Multiple myeloma

Abstract

Multiple myeloma is a clonal plasma cell malignancy that accounts for slightly more than 10% of all hematologic cancers. In this paper, we present a historically focused review of the disease, from the description of the first case in 1844 to the present. The evolution of drug therapy and stem-cell transplantation for the treatment of myeloma, as well as the development of new agents, is discussed. We also provide an update on current concepts of diagnosis and therapy, with an emphasis on how treatments have emerged from a historical perspective after certain important discoveries and the results of experimental studies.

Figures

Figure 1

Timeline depicting the history and treatment of multiple myeloma from 1844 to the present.

Figure 2

Sarah Newbury, the first reported patient with multiple myeloma. (A) Bone destruction in the sternum. (B) The patient with fractured femurs and right humerus. (C) Bone destruction involving the femur. Adapted from Solly with permission.

Figure 3

(A) Henry Bence Jones. (B) Otto Kahler (courtesy of Dr Heinz Ludwig, Vienna). (C) Jan Waldenström (courtesy of Giampaolo Merlini, Pavia, Italy).

Figure 4

Algorithm outlining the current approach to the treatment of newly diagnosed myeloma. CR indicates complete response; MPT, melphalan, prednisone, thalidomide; and VGPR, very good partial response.