When the concentration of macromolecular proteins in plasma increases and the negative charge on the surface of red blood cells decreases, the electrostatic repulsion between red blood cells decreases, resulting in an increase in the aggregation of red blood cells, which can easily form strings or piles. In patients with multiple myeloma nephropathy, blood smear examination may show red blood cells in the shape of strings of money, and later white blood cells and platelets are also reduced. The red blood cells may interfere with blood grouping. Various suboptimal symptoms can also be diagnosed microscopically as red blood cell lemon, red blood cell strings or piles. Red blood cells arranged in money strings are the result of a small area of oxygen exchange in the blood plasma, causing hypoxia in the blood, increased plasma viscosity, and slow blood flow, aggravating the lack of oxygen supply to tissues throughout the body and causing significant impairment of the entire microcirculation. Red blood cells in a money string shape early or atypical cases are easily misdiagnosed as chronic cited nephritis, pyelonephritis, aplastic anemia, rheumatoid arthritis division from, hepatic sclerosis, metastases, etc. Transplantation is therefore essential for middle-aged and elderly patients with unexplained rapid hematocrit, anemia, renal insufficiency, recurrent infections, and bone and joint pain to undergo divisional serum protein electrophoresis, bone marrow aspiration with skeletal X-ray for confirmation of the diagnosis. Erythrocyte money string formation is manifested by red blood cells resembling coins (coins) stacked in a string. By tapping the glass slides, the erythrocyte coin formation is easily separated from the erythrocyte aggregates. When shaken, the erythrocyte coin formation disappears into a single scattered erythrocyte. The morphology and appearance return to normal. This does not happen with erythrocyte aggregates.