Physicians, paraproteins and progress: diagnosis and management of myeloma

Myeloma outcomes have improved dramatically over the last decade as a result of novel therapies, several of which are now commonly continued to disease relapse. Physicians who do not work in haematology are therefore more likely than ever before to be consulted by a patient with myeloma, either for an unrelated condition or with a side effect of myeloma or its treatment. Myeloma is also the cancer most likely to be diagnosed in accident and emergency departments or by the acute physician and so an awareness of its presentation and management is especially important in these settings to enable early diagnosis and limit the morbidity associated with end organ damage. This review summarizes the presenting features of disease, diagnostic criteria for myeloma and related plasma cell disorders, and discusses current management.