Clinicopathological Spectrum of Multiple Myeloma: Experience of an Institute in Eastern India

Abstract

Introduction: Multiple myeloma (MM) is a neoplastic plasma cell disorder characterized by clonal proliferation of malignant plasma cells in the bone marrow. Incidence of MM is increasing rapidly in Asian countries. In a developing country like India diagnosis, risk stratification and access to novel treatment is still a major hurdle Objective: To study the clinico-pathological features of newly diagnosed multiple myeloma patients. Methods: This was a cross sectional hospital based retrospective study conducted in a hospital in eastern India. During the four years of study, 74 cases of multiple myeloma were diagnosed on the basis of International Myeloma Working Group: Criteria for the classification of multiple myeloma and related disorders. The clinical and laboratory characteristics of newly diagnosed patients were studied. Results: Out of the 74 patients, 69% were men and 31% were women. Median age at diagnosis was 55 years (range: 32-81 years). The commonest symptoms observed were fatigue and bone pain. Anemia was present initially in 81% of patients, hypercalcemia in 31.4%, and a serum creatinine level of 2 mg/dL or more in 24.6% patients. The most common monoclonal gammopathy was IgG kappa (44%). Diffuse pattern of bone marrow infiltration, the most common pattern observed in 59% patients. Conclusion: MM patients had male preponderance. Median age of patients was lower compared to western countries with higher percentage of patients with age less than 40 years. Quality of life in MM patients can be improved significantly if there is access to early diagnosis, risk stratification and novel treatment.