Plasma cell dyscrasias and cryoglobulins

PLASMA CELL DYSCRASIAS SEVERAL disorders characterized by the uncontrolled monoclonal proliferation of cells synthesizing antibody (immunoglobulin) are generally included in the group of plasma cell dyscrasias. Their morphological and clinical features, taken together with the type of protein produced by the neoplastic cells, permits their grouping into the three following major categories: (1) multiple myeloma, IgG, A, D, and E; (2) Waldenström's macroglobulinemia, IgM; and (3) heavy-chain diseases, gamma, alpha, and mu. A closely related variant, now more frequently encountered due to the widespread use of serum protein electrophoresis, is benign monoclonal gammopathy, a condition in which a serum protein abnormality is noted in the absence of a significant plasma cell neoplasm. As is true of most other neoplasms, the etiology of these tumors remains unknown. Multiple Myeloma—Clinical Picture Multiple myeloma, the most common of the plasma cell dyscrasias, is characterized by the infiltration of the marrow by neoplastic plasma