1.The etiology of multiple myeloma (MM) The etiology of MM is still unknown, and the study of the etiology is important to prevent the occurrence of MM and improve the prognosis, but its etiology has not been elucidated and may be related to the following factors. (1) Age and monoclonal gammaglobulinemia of undetermined significance (MGus) MM occurs mostly in middle-aged and elderly people, and is rarely seen in people under 40 years of age, so the age factor is closely related to the onset of MM. MGus refers to the presence of monoclonal gammaglobulin elevation in the blood without malignant plasma cell disease or other related diseases causing monoclonal gammaglobulin elevation, MGus patients in the process of long-term follow-up prevention MGus can be transformed into malignant plasma cell disease such as MM, which occurs mostly in the elderly, with an incidence of 3% in those over 70 years of age. This also indicates that the occurrence of MM is related to age. (2) viral infections in recent years, the relationship between viruses and MM has also attracted attention, and many studies suggest that the onset of MM may be related to viral infections. a. Human herpesvirus type 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHv). the relationship between HHV-8 and MM was first proposed in 1997 by Retting et al. We have tested 19 bone marrow biopsy specimens from MM patients and found 13 cases positive for HHV-8. HHV-8 contains some genes that are not found in other herpes viruses but are homologous to human cells, such as viral interleukin-6 (vIL-6) and vIL,8 receptor, which have a role in promoting cell proliferation and inhibiting apoptosis, so it is likely to be related to the development of MM, but further research is needed. b. Other viruses include EBV, hepatitis C virus (HcV), and human immunodeficiency virus-1 (HIV-1). Because of the pro-lymphocytic properties of HcV, autoimmune disorders can be promoted, and it is assumed that autoimmune disorders may be part of the cause of HcV-induced lymphoproliferative diseases, including MM. In addition, individual literature reports that HIV-1 is associated with the development of MM, but there is no definite conclusion yet. (3) Exposure to ionizing radiation – Some studies have shown that the incidence of MM is higher in workers involved in x-ray and in the nuclear industry than in the general population, and that long-term exposure to low doses of radiation may contribute to the development of MM. (4) related factors in the work environment such as exposure to pesticides, herbicides and agricultural chemicals farmers, exposure to various metals (such as lead, arsenic, cadmium, copper) powder and soot, benzene and other chemicals workers, leather manufacturing workers, workers engaged in oil refining and processing and paint workers, the incidence of MM will be increased to varying degrees, indicating that the occurrence of MM is related to certain factors in the environment, but further research is needed. However, further research is needed. (5) genetic factors MM is not a hereditary disease, but its development has a family tendency. Certain karyotypic abnormalities and mutations in oncogenes and oncogenes may be related to the occurrence of MM, such as high expression of c-myc gene, ms gene mutations, mutations or deletions of oncogenes Rb and P53, etc. 2, community prevention of MM (1) strengthen the awareness of environmental protection and improve the working environment farmers and workers of certain occupations who often apply pesticides and herbicides may become the high incidence of MM due to the pollution of the working environment, so the leaders of the community and enterprises and community medical workers should make the protection of these people the focus of their work, not only to strengthen the awareness of environmental protection, but also to develop practical measures. (2) Prevention of viral infections HHV-8 and EBV infections are not easy to prevent, but measures that can be taken for hepatitis C virus and HIV infections are: insisting on the use of -disposable syringes and needles, preventing blood transmission through needle sticks and other means, and strengthening education on how the virus is transmitted. Those found to be suspiciously infected should be promptly sent to hospital for examination, isolation and treatment. (3) Raise awareness and detect patients as early as possible MM prevention is difficult, but patients should be detected as early as possible, especially in elderly people MGus can be transformed into MM, so MGus patients – must be regularly followed by prevention. We have found an elderly male MGus patients, blood laboratory tests see monoclonal IgG increased, regular follow-up for 5 years are no changes, but in the 6th year of routine urine examination found urine protein (+), while the blood routine is still normal, bone x-ray examination did not see bone abnormalities, but the re-examination of blood monoclonal lgG higher than before, then the bone marrow examination showed that plasma cells have reached 25%, timely treatment according to MM, and achieved better results. The result was good. At the same time, the elderly should be alerted to unexplained bone pain, weakness (a symptom of anemia) or frequent recurrent infections, proteinuria, etc., and should be instructed to go to the hospital for examination in time to make a clear diagnosis and give correct treatment as soon as possible.