10% in bone marrow.o In the previous question it has already been stated that in multiple mycloma the plasma cells secrete abnormally large amount of immunoglobulin. So, how is it possible for hypogammaglobulinemia to occur in multiple myoloma.J In about one quaer of patients with multiple myeloma only light chains are produced. These light chains are called Bence Jones protein. The characteristic feature of these light chains is that they are very small and are rapidly excreted in the urine. So all the abnormal immunoglobulin that is secreted in multiple myeloma is excreted.o Another point, which should be kept in mind is that the normal plasma cells in a patient with myeloma are not capable of immunoglobulin synthesis. So a situation develops where all the abnormally synthesized immunoglobulin by the neoplastic cells is excreted where as the remaining normal plasma cells are incapable of normal immunoglobulin synthesis. Thus, there is little immunoglobulin left in the serum causing hypogammaglobulinemia.o Renal failure may occur because of hypercalcemia, damage by Bence Jones protein, urate nephropathy an Amyloidosis (AL type).o ESR is increased due to hyperviscosity.">