We find the case reported by Dr Law of great interest and agree with his comments. Indeed, our patients may be considered to have an increased risk of developing myeloma (that is, premyeloma). One of them (patient 2 of our report) was seen recently, and the level of the monoclonal spike and the number of plasma cells in the bone marrow had increased from previous observations (and after five years from the initial evaluation).While our paper was being published, Mundy et al1 reported on a factor that was present in the supernatant fluid of bone marrow cultures of patients with myeloma that accelerated osteoclastic bone resorption in vitro. It is possible that an abnormal, albeit small, clone of plasma cells can produce a serum monoclonal gammopathy and a factor (possibly a "hormone") leading to osteoporosis and that the gammopathy and the osteoporosis may or may not
Law IP, Maldonado JE, Bayrd ED, Riggs BL. Pseudomyeloma: A Separate Entity or a Coincidence?-Reply. Arch Intern Med. 1976;136(1):119–120. doi:10.1001/archinte.1976.03630010096024
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