Clinicopathological profile of multiple myeloma at a tertiary care hospital in a resource-poor setting: A retrospective study
Prapannajeet Biswal, Raghvendra Deo Pandey, Gurmeet SinghObjectives:
The objective of this study was to study the clinicopathological profile of multiple myeloma (MM) presenting to Jawaharlal Nehru Hospital and Research Center (JLNH&RC) Bhilai and document the disease in central India.
Material and Methods:
This was a retrospective observational study using patient data from January 2013 to December 2019. The clinical and radiological findings, laboratory parameters, and bone marrow examination were analyzed.
Results:
About 35.38% of patients presented in the 6th decade of life with a male-to-female ratio of 1.3:1. About 91.93% of patients had low backache and bone pain, and 96.92% of patients had Anemia. About 63.01% of patients had serum creatinine >2 mg/dL, and 92.30% of patients had A/G ratio reversal. About 64.70% of patients had serum beta-2 microglobulin (≥3.5 μg/mL). About 80.7% had osteolytic lesions, predominantly in the skull and pelvis. About 46.15% of patients had >50% plasma cells on bone marrow aspirate. About 85.71% exhibited hypercellularity, and 8.92% of patients had grade 2 marrow fibrosis. About 76.92% of patients presented with Durie Salmon stage III disease, and 58.82% presented with international staging system (ISS) stage II disease.
Conclusion:
MM has an inconsistent clinical presentation with multiple system involvement. It should be considered as a differential in patients above 50 years of age presenting with normocytic normochromic Anemia and bony pain. Bone marrow study is important in resource-poor settings where specialized laboratory testing is limited. The Durie and Salmon staging and the ISS can be used for the prognosis with equal efficacy.