Plasma Cell Disorders

Clonally restricted plasma cell disorders are frequent reason for consultation during inpatient consultation service. A careful evaluation includes uncovering paraproteinemia with the ability to induce end-organ damage. In patients with paraprotein detected in serum protein electrophoresis (SPEP), anemia, renal failure, hypercalcemia, and evidence of bone lytic lesions should prompt evaluation for multiple myeloma. However, paraproteinemia can develop without evidence of end-organ damage requiring adequate risk stratification and monitoring aimed at identifying early disease progression. In this chapter, we discuss clinical presentation, diagnostic algorithms, risk stratification tools, and management of patients presenting with myeloma.