TIMELINE IN THE HISTORY OF MULTIPLE MYELOMA.

Multiple myeloma is a multifocal neoplastic proliferation of plasma cells, usually associated with M-protein in serum and or urine and evidence of organ damage related to the disease.

In this post, we shall see how this disease was first described and the various timelines in the clinical presentation and  laboratory investigations.

1844	Solly described the first well documented case of multiple myeloma (MM) in Sarah Newbury , only based on clinical presentation.
1845	William MacIntyre, Henry Bence Jones, John Dalrymple examined a patient with vague pain in chest, back and pelvis. Bence Jones found a substance in the urine that precipitated by addition of nitric acid. He also noted that the precipitate was soluble in boiling water but re-precipitated after the urine was cooled.
1873	Von Rustizky introduced the term multiple myeloma as he found eight separate tumors of  bone marrow, soft in consistency and reddish in colour.
1889	Kahler described pallor, skeletal pain, anemia, albuminuria, a precipitable urinary protein in a 46 year old physician with MM
1928	Geschickter and Copeland reviewed 412 cases reported in literature since 1848
1939	Longsworth & co-workers did electrophoresis in MM patients and demonstrated the tall narrow-based “church spire” peak.
1948	Bayrd showed for the first time that patients with very immature plasma cell morphology had a shortened survival
1953	Grabar & Williams described immunoelectrophoresis in the diagnosis of MM
1956	Korngold from Memorial Hospital and Rose Lipari, his technician identified different classes of Bence Jones proteins (BJP). They also demonstrated that antisera to BJP also reacted with myeloma protein in the blood. The two classes of BJP have been designated as kappa and lambda to honour them.
1958	Harold Porter from England split the antibody as heavy chains and light chains.
1961	Waldenstrom introduced the concept of monoclonal versus polyclonal gammopathies in the Harvey Lecture series. Patients with monoclonal proteins have multiple myeloma or macroglobulinema, while those with polyclonal hypergammaglobulinemia have an inflammatory or infectious process.
1962	Gerald M Edelman and Rodney R Porter discovered the chemical structure of antibodies, for which they got Nobel Prize in Medicine or Physiology in 1972.
1964	Wilson described immunofixation or direct immunoelectrophoresis
1967	Putman et al different BJP were different in their peptide sequence.

See you in the next post with some other  interesting aspects of MM.

References:

Domenico Ribatti. A historical perspective on milestones in multiple myeloma research. Eur J Haematol.2018 Mar;100(3):221-228.

                                                                            Written by Dr.Priyavadhana B