Multiple myeloma and plasma cell disorders

Plasma cell disorders encompass a number of diagnostic entities, with the most common being multiple myeloma. These disorders typically affect multiple organ systems, and patients can present with a spectrum of symptoms. Evaluation of these disorders requires a comprehensive set of laboratory and radiographic tests. Common to these disorders is the finding of a monoclonal protein in the serum, or monoclonal plasma cells on biopsy. Risk stratification of these disorders is important for determining prognosis and treatment. Treatment involves chemotherapy, steroids, and sometimes additional modalities such as stem cell transplant, radiotherapy, or surgery. While these disorders generally remain incurable, both therapy and prognosis have significantly improved with the introduction of immunomodulatory agents and proteasome inhibitors, and will likely continue to improve with the advent of immunotherapies and other targeted agents.