Multiple Myeloma is a neoplastic disease of the plasma cells characterized by clonal proliferation of terminally differentiated B lymphoid cells, which accumulate in bone marrow and produce a monoclonal protein (Immunoglobulin), usually IgG or IgA, often referred to as M or myeloma protein. AIMS AND OBJECTIVESOur study aims to describe the common clinical and laboratory features, stages and outcome of patients with Multiple Myeloma coming to a Tertiary Care Center in North East India. MATERIALS AND METHODSNewly diagnosed and previously diagnosed untreated patients of MM coming to Assam Medical College over a period of one year from June 2013 to May 2014 were randomly included in this prospective observational study. Diagnosis was confirmed by the 2009 updated criteria of International Myeloma Working Group and clinical features, laboratory findings and outcome were studied. RESULTS AND OBSERVATIONS44 Multiple myeloma mostly from 5 th and 6 th decade with the age varying from 38 to 82 and a mean age of 57.7 years (SD 10.29); 27 (61%) patients were male and 17 (39%) were females with a male-to-female ratio of 1.6:1; 38 (86%) presented with backache and other bone pains, 35(80%) had generalized weakness and easy fatigability, 13 (30%) had symptoms of spinal cord compression, 14 (32%) had fever. On examination 37 (84%) had pallor, 34 (77%) had bony tenderness, 14 (32%) had paraplegia; 40 (91%) cases revealed positive M Band by serum protein electrophoresis. In rest of the 4 cases, band was determined by immunofixation method. Urinary Bence-Jones protein was estimated in 28 out of 44 patients and of them 4 (14%) were positive; 40 (91%) had radiologically detectable abnormalities; 35 (80%) had lytic lesions, 17 (39%) had pathological fractures, 21 (48%) had generalized osteoporosis and only 4(9%) had normal skeletal survey. Out of 35 cases of lytic lesions, most frequent area was spine in 25 (71%); 7 (16%) cases were found to be in stage I, 20 (45%) were found to be in stage II and 17 (39%) were in stage III. CONCLUSIONWe conclude that though most patients were in sixth decade, but we got significant involvement in younger age group. Bone pain, mostly low backache was the most common presenting symptom along with fatigue and weakness. Majority of patients were in higher stages (ISS II, III) at the time of diagnosis and severe anaemia, lytic lesions, pathological fractures and renal insufficiency were most observations in these patients in higher stages.
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