An Analysis of the Clinical and Laboratory Profiles of Patients Diagnosed with Multiple Myeloma in a Tertiary Care Hospital

Document Type : Original Article


1 Department of Pathology, Vyas Medicity Hospital, Jodhpur, India

2 Department of Pathology, Mahatma Gandhi Medical College and Hospital, Jaipur, India


Background and aim: Multiple myeloma (MM) is a plasma cell neoplasm characterized by the proliferation of terminally differentiated B lymphoid cells, producing monoclonal antibodies and significant end-organ damage. It is the second most common hematological malignancy after lymphoma, resulting in considerable morbidity and mortality. This study aimed to explore MM's clinical and laboratory characteristics in a specific region with limited resource settings, emphasizing the importance of early detection and intervention.
Material and methods: The present study was performed from January 2019 to June 2022 in a tertiary healthcare facility. A detailed clinical history was recorded. Various laboratory parameters were assessed. Diagnosis was established using the criteria provided by the International Myeloma Working Group (IMWG) and the World Health Organization (WHO). The staging of the patients was conducted according to the Durie-Salmon staging system and CRAB criteria. Prognostic factors were assessed using the ISS system.
Results: Fifty-four newly diagnosed cases were studied. The results reinforced that MM primarily affects the middle-aged and elderly, particularly males. Common clinical presentations included generalized weakness, pallor, and renal dysfunction, while anemia and thrombocytopenia were frequently observed. Bone marrow analysis revealed a high percentage of plasma cells, with most cases categorized as Durie-Salmon stage III.
Conclusions: This research contributes to a better understanding of MM's clinical and laboratory characteristics. Further research and collaborative efforts involving larger cohorts and current staging systems are recommended for deeper insights into this complex hematological malignancy, ultimately improving patient care and outcomes.


Main Subjects

[1] Padala SA, Barsouk A, Barsouk A, Rawla P, Vakiti A, Kolhe R, et al. Epidemiology, staging, and management of multiple myeloma. Medical Sciences. 2021;9(1):3.
[2] Heider M, Nickel K, Högner M, Bassermann F. Multiple myeloma: molecular pathogenesis and disease evolution. Oncology Research and Treatment. 2021;44(12):672-81.
[3] Jaffe R. WHO classification of tumours of haematopoietic and lymphoid tissues. Swerdlow SH, editor. Lyon, France: International agency for research on cancer; 2008;358-60.
[4] Greer JP, Arber DA, Glader B, List AF, Means RT, Paraskevas F, et al. Wintrobe's clinical hematology. Lippincott Williams & Wilkins; 2013.
[5] Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor I, Curado MP, et al. Global burden of multiple myeloma: a systematic analysis for the global burden of disease study 2016. JAMA oncology. 2018;4(9):1221-7.
[6] Subramanian R, Basu D, Dutta TK. Prognostic significance of bone marrow histology in multiple myeloma. Indian Journal of Cancer. 2009;46(1):40-5.
[8] Kalita LK, Kalita C, Gogoi PK, Sarma UC. A clinicoepidemiological study of multiple myeloma− a hospital based study at Gauhati Medical College and Hospital, Guwahati, Assam. J Evid Based Med Health. 2016;3(36):1788-94.
[9] Nandakumar A. National Cancer Registry Programme. Consolidated Report of the Population Based Cancer Registries. Incidence and Distribution of Cancer: 1990–96. Indian Council of Medical Research, New Delhi. Cancer. 2019;125:3184-97.
[10] Greipp PR, Miguel JS, Durie BG, Crowley JJ, Barlogie B, Bladé J, et al. International staging system for multiple myeloma. Journal of clinical oncology. 2005;23(15):3412-20.
[11] Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, et al. Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. Journal of clinical oncology. 2015;33(26):2863-9.
[12] Pegu AK, Dutta A, Todi VK. Clinical profile of multiple myeloma in a tertiary care center from North East India. Cough. 2016;5(52):3382-85.
[13] Sharma S, Suri J, Kour B. Clinicopathological study of spectrum of plasma cell dyscrasias in a tertiary care centre-retrospective four year study. Indian Journal of Pathology and Oncology. 2020;7(1):158-63.
[14] Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, et al. Review of 1027 patients with newly diagnosed multiple myeloma. InMayo Clinic Proceedings 2003;78(1):21-33.
[15]  Sultan S, Irfan SM, Parveen S, Ali H, Basharat M. Multiple Myeloma: A retrospective analysis of 61 patients from a tertiary care center. Asian Pacific Journal of Cancer Prevention. 2016;17(4):1833-5.
[16] Mishra D, Meena G, Gandhi S, Prasad K. A study of clinical profile and laboratory parameters in multiple myeloma at SMS Medical College & Hospital, Jaipur. Paripex Ind J of Research. 2021;10(10):11-14.
[17] Shin J, Koh Y, Youk J, Kim M, Kim BS, Choi CW, et al. Clinicopathological characteristics of extremely young Korean multiple myeloma patients: therapeutic implications. The Korean journal of internal medicine. 2017;32(4):722-30.
[18] Jakhetia H. Clinicopathologic profile in Multiple Myeloma: A case series of 30 cases. Journal of Advanced Medical and Dental Sciences Research. 2019;7(9):142-7.
[19] Kaushik R, Thakur RK, Gulati A, Sharma SK. Multiple myeloma: clinico-hematological profile in a tertiary care hospital: a three years study. Annals of Pathology and Laboratory Medicine. 2017;4(5):270-5.
[20] Sheik N, Variganji SK, Inugati VR. Clinico-hematological profile of multiple myeloma in a teaching hospital-a 2 year study. IP Arch Cytol Histopathol Res. 2019;4(04):305-9.