Multiple Myeloma: Clinicohaematological Study of 3 Years at a Tertiary Care Centre

Abstract

BACKGROUNDMultiple myeloma is also called as plasma cell myeloma or myelomatosis. It is a malignant clonal proliferation of neoplastic plasma cells within the bone marrow. Its incidence increases with age. Multiple Myeloma accounts for 1% of all human cancers and 10% of all haematological malignancies. We wanted to study clinical presentation of multiple myeloma and haematological parameters along with bone marrow aspiration with biopsy interpretations. METHODSThis is descriptive, analytical study. The total 212 bone marrow aspirations were done during study period at Department of Pathology and evaluated for MM. The Study period was 3 years from January 2016 to December 2018 at our tertiary care hospital. Detailed clinical data including all biochemical investigations, routine and specific haematological investigations were done. The imaging findings, serum electrophoresis, urine analysis etc were considered. The bone marrow aspiration and biopsy study were done. RESULTSIn data analysis for 3 years, total 12 cases of multiple myeloma were diagnosed. The male: female ratio was 2:1. The age range was 55-79 years, with mean age 67 years. The common clinical presentation was bony pain (66%), followed by renal failure (25%), neurological symptom (pain) (41.7%), easy fatigability (66.7%), infection (6%), etc. On investigation, it was observed that anaemia (75%), lymphocytosis (33.3%), elevated ESR (66.7%), increased serum creatinine (83.3%), increased serum calcium (91.7%), BJ proteinuria (50%) were seen in various cases. On serum electrophoresis, M-band was noted in all patients. Bone marrow plasmacytosis was noted in 100% cases with mean count was 41%. On radio imaging 75% showed bony lytic lesions. CONCLUSIONSElderly patients with unexplained anaemia, bony pain and renal manifestations should be investigated for multiple myeloma. Bone marrow aspiration, electrophoresis, and related investigations. It plays an important role in diagnosis and management of multiple myeloma cases.

Survival Outcomes of Newly Diagnosed Multiple Myeloma at a Tertiary Care Center in North India (IMAGe: 001A Study)

“…Infection at diagnosis was found in 16%-23% in the published literature, which is higher than 14% seen in our study. 15 , 18 , 30 The presence of infections led to poorer survival; however, the difference was not significantly different in our study (Fig 2 D). Barila et al reported a median OS of 42 months among patients with infections compared with 54.36 months in our study.…”

“…The incidence of weight loss was only 31% in the study population, coinciding with the western literature (24%) and contrary to the reported Indian data (75%). 15 , 17 The incidence of weight loss was significantly less in the western population as compared with the Indian population, which can be attributed to lower per-capita income, leading to more impoverished living conditions, overcrowding, and malnutrition. 15 , 17 These factors were mostly not applicable to our clientele owing to better standards of living and per-capita income.…”

“… 15 , 17 The incidence of weight loss was significantly less in the western population as compared with the Indian population, which can be attributed to lower per-capita income, leading to more impoverished living conditions, overcrowding, and malnutrition. 15 , 17 These factors were mostly not applicable to our clientele owing to better standards of living and per-capita income. The median survival was significantly lower among patients with weight loss (21.09 months v 84.02 months, P = .01; Fig 2 C) comparable with western literature (25.5 months).…”

The Experience and Needs of Myeloma Patients: Exploring Race and Ethnicity

“…In fact, Black patients face double the mortality risk compared to other myeloma populations [1]. Given these findings, elderly patients presenting with unexplained anemia, bone pain, and renal symptoms must undergo prompt evaluation for MM [10].…”