History of multiple myeloma.

Multiple Myeloma has been recognized since Ancient Times. The first well-documented case was reported in 1844 by Samuel Solly. The most commonly recognized case is that of Thomas Alexander McBean, a highly respectable tradesman from London in 1850. Mr. McBean excreted a large amount of protein that was described by Henry Bence Jones in the middle of the 19th century. Jones was a well-known physician and made many contributions to medicine. One of the best known cases of multiple myeloma was that of Dr. Loos that was reported by Otto Kahler. The recognition of plasma cells and subsequently their product, a monoclonal protein has been described in detail. The authors have reviewed the treatment of multiple myeloma including the novel agents, thalidomide, bortezomib and lenalidomide.

A history of the kidney in plasma cell disorders.

BACKGROUND: The kidneys are commonly injured in plasma cell dyscrasias. METHODS: We reviewed the pertinent medical literature related to the historical development of clinical nephrology and diagnostic renal pathology; early case reports of patients with plasma cell disorders; and historical descriptions of multiple myeloma, amyloidosis, and the renal disorders that are associated with these conditions. RESULTS: Medieval uroscopists recognized proteinuria, and in 1827 Richard Bright first linked proteinuria to both dropsy (edema) and the autopsy finding of chronically diseased, scarred kidneys. In the 1840s, Henry Bence Jones and William Macintyre described a peculiar form of proteinuria in a middle-aged English grocer with fragile, tumor-riddled bones; this proteinuria became known as 'Bence Jones type'. It was initially believed that Bence Jones proteins were harmless to the kidney, but after 1899 (when myeloma cast nephropathy was recognized), investigators observed numerous renal injury patterns associated with plasma cell dyscrasias. Gross observations of 'waxy degeneration' or 'lardaceous change' in organs including the kidney yielded to the misnomer 'amyloid' in 1854, when iodine staining suggested to Rudolf Virchow that the strange material present in these conditions was a form of starch or cellulose. During the 20th century, biochemists and physicians carefully studied patients with myeloma, in order to better define the nature and structure of normal and pathological immunoglobulins. CONCLUSION: Historical understanding of the kidney in plasma cell disorders reflects developments in understanding of the anatomy and physiology of the kidneys in health and in disease.