Multiple myeloma is a cancer of plasma cells that accounts for approximately 10 of all haematological malignancies (Smith Yong, 2013). Over 4700 cases are diagnosed annually in the UK, with a median age at diagnosis of between 65 and 70 years (Cancer Research UK, 2015). Presenting symptoms and signs can vary, with a third of all cases being diagnosed after an incidental finding of a raised ESR or immunoglobulins (Smith Yong, 2013). Bone marrow infiltration can lead patients to present with pain, fractures, spinal cord or nerve root compression and symptoms of hypercalcae-mia, while bone marrow failure can result in anaemia and lethargy, recurrent bacterial infections and easy bruising or bleeding. Excess monoclonal antibodies can cause renal impairment, in addition to hyperviscosity, which increases the risk of cerebrovascular events (Smith Yong, 2013).
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