Fever, Cough, Back Pain and Fatigue

Robert A. Kyle, MD, and Michael Tomasson, MD

Dr. Kyle: Mayo Clinic College of Medicine
Dr. Tomasson: Washington University School of Medicine, St. Louis, MO

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

This case was reviewed and updated in March 2011 by Dr. Shirley Parker Levine and members of the Teaching Cases Subcommittee.


Dispenzieri A, Katzmann JA, Kyle RA, et al. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined signficance: a retrospective population-based cohort study. Lancet 2010;375(9727):1721-1728.

Dispenzieri A, Kyle RA, Katzmann JA, et al. Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma. Blood 2008;111(2):785-789.

Fonseca R. Strategies for risk-adapted therapy in myeloma. Hematology 2007:304-310.

Hideshima T, Bergsagel PL, Kuehl WM, Anderson KC. Advances in biology of multiple myeloma: clinical applications. Blood 2004;104:607-618.

Kyle RA, Gertz MA. Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Sem Hematol. 1995;32:45-59.

Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78:21-33.

Kyle RA, Therneau TM, Rajkumar SV, et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med. 2002;346:564-569.

Landgren, O. Monoclonal Gammopathy of Undetermined Significance and Smoldering Myeloma: New Insights into Pathophysiology and Epidemiology. Hematology 2010:295-302.

Landgren O, Kyle RA, Pfeiffer RM, et al. Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study. Blood 2009;113(22):5412-5417.

Rajkumar SV, Kyle RA. Multiple myeloma: diagnosis and treatment. Mayo Clinic Proc. 2005;80:1371-1382.

Royer B, Arnulf B, Martinez F, et al. High dose chemotherapy in light chain or light and heavy chain deposition disease. Kidney Int. 2004;65:642-648.

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