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The study of multiple myeloma has fascinated and challenged a multitude of workers in basic science and clinical medicine. Nevertheless, progress in treating this disease has been slow. The cause is unknown, and because the ancestral myeloma cell is unknown, biologic and molecular aspects of the disease are difficult to study. A major consequence of our ignorance is that therapeutic advances have been minimal.
Indeed, when I entered medical school in 1967, the sixth and last single-authored edition of Maxwell M. Wintrobe's Clinical Hematology (Philadelphia: Lea and Febiger) stated that the cause of multiple myeloma was unknown. As for treatment,
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