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The overgrowth of plasma cells in multiple myeloma is associated with a unique abnormality in the synthesis of protein. Abnormal components occur in the sera of patients with this disease, sometimes in sufficient amount to produce hyperproteinemia, and the majority excrete Bence Jones protein in the urine. The relation between plasma cell proliferation and the production of the abnormal proteins, and the relation of the serum components to Bence Jones protein have been obscure. The degree of hyperproteinemia and the amount of Bence Jones protein excreted in the urine vary greatly in patients who appear to have equally progressive and anatomically extensive disease. Large amounts of abnormal protein have been present in the sera of patients with, as well as without, Bence Jones proteinuria, and vice versa. The anomalous serum and urinary proteins vary from patient to patient in electrophoretic mobility, solubility in salt solution, molecular weight and antigenicity (1-11). It has been suggested that the serum increments in multiple myeloma, especially those with gamma globulin characteristics, may represent antibodies to Bence Jones protein (12). On the other hand, the serum components, which are produced in all likelihood by the abnormal plasma cells (9, 13) may represent a perversion in the normal processes of globulin production (14-16). As to the origin of Bence Jones proteins, compounds of such relatively small molecular size are readily excreted by the kidney (17, 18). Large concentrations have not been found in the serum (5). Bence Jones proteins could possibly be derived from the abnormal serum constituents, since the latter have a molecular size about three to six times as great

MULTIPLE MYELOMA. IV. ABNORMAL SERUM COMPONENTS AND BENCE JONES PROTEIN 1