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November 9, 1970

Diagnosis and Treatment of Multiple Myeloma

Author Affiliations

Bar-Ilan University Ramat-Gan, Israel

JAMA. 1970;214(6):1124. doi:10.1001/jama.1970.03180060098036

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When we approach this monograph authored by a brilliant clinical investigator who has contributed fundamental information on immunoglobulins, our expectations understandably run high—and they are not disappointed. The exposition combines thorough bedside and laboratory study of 140 patients with multiple myeloma, and a highly critical evaluation of pertinent world literature. Thus, a comprehensive picture emerges of the disease, encompassing incidence, cytologic, hematologic, roentgenologic features, and clinical symptoms and course. Particular attention is given to structure, quantitation, and classification of abnormal serum proteins. The author questions many previously claimed correlations between morphologic and biochemical findings and diagnosis and prognosis, including recent data purporting to show characteristic chromosomal abnormalities in multiple myeloma and other "gammapathies." On the other hand, his studies confirmed that plasma cells with strongly eosinophilic cytoplasm—"flaming cells"—are frequently associated with prevalence of the IgA serum fraction.

The book offers much more than promised in the title. Many fascinating aspects