Biochemical characterization of multiple myeloma patients across ISS stages – a data base workup from a tertiary care hospital in India

Noorjahan Mohammed, Sai Baba SS Kompella, Yadagiri Bhodramoni, Sadashivudu Gundeti, Bhushan Raju Sree


Background: Multiple myeloma (MM) is slowly becoming a huge medical burden, challenging the health-care systems of Asian countries. Because of the unavailability of widespread access to various modalities of investigations, and paucity of well compiled data on common presenting features and various laboratory parameters in various stages of MM in India, the diagnosis is usually delayed till complications begin to occur. This study is an attempt to fill this gap and to establish database for future reference.

Methods: The study was conducted in a tertiary health care centre over a span of 3 years and 94 patients diagnosed as MM with complete workup including beta2 microglobulin (β2M), bone marrow plasma cell percentage, serum protein electrophoresis, serum and urine Immunofixation and serum Free Light Chains (FLC) were included. The various laboratory parameters were statistically analyzed across ISS stages I, II and III.

 Results: We found a male to female ratio of 1.47:1. The mean age of patients was 55.5±11.78 yrs. Backache was the most frequent presentation (30%) of the patients followed by generalized weakness (22%). The percentage of plasma cells, hemoglobin, urea, creatinine, uric acid, calcium and β2M showed significant difference across the stages. 38.3% of the patients were in stage III, 29.8% in stage II and 31.9% in stage I. IgGκ type constituted 70%, other fraction being IgGλ (10%), IgMκ (10%), IgAκ (5%) and IgAλ (5%). M band was not seen in 11% of patients.

Conclusion(s): The presentation of MM is nonspecific and patient can come with varied presentations at onset. We have biochemically characterized the three stages of MM and this will form a basis for further larger studies on these lines and to develop stage-based algorithms for early and better diagnosis and prognosis of MM.

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