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Central nervous system involvement is a rare complication of multiple myeloma with extremely poor prognosis as it usually fails to respond to therapy. We present 13 cases diagnosed at two centers in Budapest and review the current literature. The majority of our cases presented with high-risk features initially; two had plasma cell leukemia. Repeated genetic tests showed clonal evolution in 3 cases. Treatments varied according to the era, and efficacy was poor as generally reported in the literature. Only one patient is currently alive, with 3-month follow-up, and the patient responded to daratumumab-based treatment. Recent case reports show promising effectivity of pomalidomide and marizomib.

It is anticipated that this recommendation will cover the whole of the UK. Wales has been a pioneer in the process of haematology harmonization, as a result of the introduction of a national laboratory information management system for Wales, and is represented on the Pathology Harmony Haematology Sub-Group. Scotland is represented on the Pathology Harmony Committee and the Scottish representatives have supported the earlier changes in Clinical Chemistry.The process to date has not been as easy as might be envisaged; it has taken much effort to reach this stage of the project. The haematology sub-group is also working closely with the DH advisor for the National Laboratory Medicine Catalogue (NLMC) on the incorporation of the changes of nomenclature and units into the NLMC, the standard for pathology test requests and results reporting, under collaborative development by the RCPath, the Department of Health and NHS Connecting for Health. The future challenges will be to move on to other areas of standardization including the development of consensus reference intervals for FBC and expansion to other areas of haematology, e.g., Hb A 2 , haematinic assays, coagulation factor assays and leucocyte immunophenotyping. The issue of harmonized reference intervals for the extended FBC is not expected to be straightforward, given the variation seen with age, ethnic differences and physiological state, e.g., pregnancy. For harmonized reference intervals to be effective, they must be widely adopted and this will not happen without a pragmatic approach and majority agreement within haematology. Impact of polymorphic variation at 7p15.3, 3p22.1 and 2p23.3 loci on risk of multiple myeloma Contribution and acknowledgementsMultiple myeloma (MM) is the second most common haematological cancer after non-Hodgkin lymphoma (Raab et al, 2009), with a worldwide age-standardized rate of 1Á5/ 100 000 new cases every year. In Europe the incidence is slightly higher, with 4Á6/100 000 and 3Á2/100 000 new cases, respectively in men and women (Ferlay et al, 2010). MM is characterized by the proliferation of a single clone of plasma cells located in the bone marrow that, in the most advanced stages, can migrate to extra-medullary districts. Several lines of evidence suggest that genetic factors are involved in MM pathogenesis (Altieri et al, 2006), however the genetic basis of the disease is largely unknown. Recently the first genome-wide association study (GWAS) of MM based on a meta-analysis of German and UK datasets reported that variation at 2p23.3 (rs6746082), 7p15.3 (rs4487645) and 3p22.1 (rs1052501) influences MM risk (Broderick et al, 2011).Because of the capricious nature of association studies, multiple replications in independent populations are highly desirable to lend credibility to the findings of a study. In addition, replication in different populations helps to generalize findings from the GWASs. Therefore we genotyped the single nucleotide polymorphisms (SNPs) rs6746082, rs4487645 and rs1052501 in 1139 MM cases and 1352 contr...

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