The disease process of multiple myeloma has several factors that cause elevated erythrocyte sedimentation rate ESR. First of all, abnormal proteins produced by myeloma cells or rather immunoglobulins and their components may cause the increase in blood viscosity which leads to an increased ESR. Myeloma cells can cause inflammation and increase the secretion of some proteins that influence sedimentation rate. The effect of the disease on marrow function, and in particular its overproduction with plasma cells may also impact ESR levels. Elevated levels of the ESR are quite general in pricing an infection and can act as a predictor to determine how much myeloma-related irregularities is presently affecting one’s body. Monitoring of ESR regularly with other clinical parameters helps to evaluate disease progression and the patient’s response to treatment in multiple myeloma.