The pathophysiology behind myeloma-induced high-output failure is not entirely understood, but hypotheses include increased splenic flow due to splenomegaly, a plasma cell produced cytokine mediated process (IL-2, IL-6, Gamma Interferon) or perhaps innumerable, small diffuse intramedullary arteriovenous fistulas [3]. The gene discussed is IL2; the disease is plasma cell myeloma.