History of multiple myeloma

Abstract

Myeloma has been present since antiquity, but the rich history of plasma cell neoplasms including multiple myeloma begins with case reports of “mollities ossium” in the early nineteenth century that focused on the bone lesions that are characteristic of what would later became known as multiple myeloma. In 1845, chemical pathologist Henry Bence Jones and clinical consultant William Macintyre described a novel form of proteinuria in a middle-aged English grocer with fragile bones and pathological fractures; this proteinuria became known as “Bence Jones protein.” Patients with mollities ossium and Bence Jones proteinuria typically died within a few years of diagnosis, often after futile treatment with nonspecific remedies such as quinine, rhubarb, orange peel, iron salts, and arrowroot. During the twentieth century, biochemists and physicians studied blood and urine from patients with myeloma systematically and in increasing detail, resulting in important insights into the nature and structure of normal and pathological immunoglobulins. By the beginning of the twenty-first century, the genetic basis of myeloma and disease pathophysiology was well understood. Today more than a dozen approved drugs with diverse mechanisms of action, as well as other therapies such as autologous stem cell transplantation, are extending the lives of patients. This chapter reviews the history of myeloma from its first description to the present.