Multiple Myeloma: Clinico-hematological profile in a tertiary care hospital: a three years study.
Keywords:
Multiple myeloma, bone marrow
Abstract
Background: To analyze the clinical findings and haematological profile of multiple myeloma patients.Material and methods: All newly diagnosed patients of multiple myeloma between January’ 2013 to December’ 2015 in the department of pathology, Indira Gandhi Medical College, Shimla were the study subjects. The history and clinical findings were recorded. All relevant blood, radiological investigations including peripheral smears, bone marrow aspiration and biopsy were done.Results: Fifty one patients were diagnosed with multiple myeloma and they comprised 19% of all haematological malignancies. Out of these, 30 were males and 21 females with a mean age of presentation 58.38 years. The commonest presenting complaint was bone pain followed by fever, CKD and bleeding disorder. Common clinical findings were anemia, osteolytic lesions and renal insufficiency. M band was seen in 83% of patients on serum protein electrophoresis. On bone marrow examination, majority (53%) of patients had plasmablastic morphology while, 47% had plasmacytic features. Diffuse pattern of infiltration on bone marrow biopsy was observed most commonly in 68.3%patients.Conclusion: The present study concluded that multiple myeloma is a disease of middle age and elderly with male preponderance. The clinical presentation varies with bone pain being the most common presenting complaint. Morphologically,plasmablastic morphology predominated on bone marrow aspiration while diffuse pattern of infiltration was observed on bone marrow biopsy.DOI: 10.21276/APALM.1245References
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12.Bartl R, Frisch B, Burkhardt R, Fateh-Moghadam A, Mahl G, Gierster P et al . Bone marrow histology in myeloma: Its importance in diagnosis, prognosis, classification and staging. Br J Haematol 1982; 51:361-75.
13.Stifter S, Babarovic E, Valkovic T, Bekafigo IS, Stemberger C, Nacinovic A et al. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagnostic Pathology 2010; 5: 30.
14.Diwan AG, Gandhi SA, Krishna K, Shinde VP. Clinical profile of the spectrum of multiple myeloma in a teaching hospital. Medical Jr. of Dr. D. Y. Patil University. 2014; 7(2): 185- 8
15.Rajkumar SV, Greipp PR. Prognostic factors in multiple myeloma. HaematolOncolClin North Am 1999; 13:1295.
16.Kapoor R, Bansal M, Sastri GJ, Sandhu MS, Garg M,Sharma SC.Clinical Spectrum and Prognosis of MultipleMyeloma in Patients Younger than 30 Years : Is it Different from the Elderly ?2006;8 ( 4): 225-228.
17.Guadarrama MBR, Medina CAM, Martinez EA. Plasma Cell Neoplasms, Clinicopathological Characteristics and Immunophenotype of 21 Patients. OJPathology. 2012; 2:127-132.
18.Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al. Review of 1027 Patients With Newly Diagnosed Multiple Myeloma. Mayo Clin Proc. 2003; 78: 21-23.
19.Haemoglobin concentrations for the diagnosis of anaemiaand assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.1)
2.Jaffe ES, Nancy LH, Harald S, Peter GI. Classification of lymphoid neoplasms: the microscope as a tool for diseasediscovery. Blood Jr. 2008 ; 112(12): 4384–4399.
3. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood Jr.2016; 127(20): 2375-2390.
4. Subramanian R, Basu D, Dutta TK. Prognostic significance of bone marrow histology in multiple myeloma. Indian J. Cancer. 2009; 46(1): 40-5.
5.Kaur P, Shah BS, Bajaj P. Multiple myeloma: A clinical and pathological profile. G. J.O. 2014; 16: 14-20.
6.Kalita LK, Kalita C, Gogoi PK et al. A clinic- epidemiological 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- 1794.
7.National cancer registry programme. Consolidated report of population based cancer registries 1990- 1996, Indian Council of medical research, New Delhi. 2001.
8.Lichtman MA, Kipps TJ, Seligsohn U, Kaushansky K, Prchal JT. Williams Hematology. 8thed. New York, NY : McGraw Professional; 2010.
9.Kuehl WM, Bergsagel PL. Molecular pathogenesis of multiple myeloma and its premalignant precursor. J Clin Invest. 2012; 122(10): 3456- 3463.
10.Heher EC, Rennke HG, Laubach JP, Richardson PG. Kidney Disease and Multiple Myeloma. Clin J Am SocNephrol 8: 2007–2017, 2013. doi: 10.2215/CJN.12231212
11.Bain BJ, Clark DM, Wilkins BS. The normal bone marrow. In: Bain BJ, Clark DM, Wilkins BS, editors. Bone Marrow Pathology. 4th ed. Singapore: Wiley-Blackwell; 2010:421-60.
12.Bartl R, Frisch B, Burkhardt R, Fateh-Moghadam A, Mahl G, Gierster P et al . Bone marrow histology in myeloma: Its importance in diagnosis, prognosis, classification and staging. Br J Haematol 1982; 51:361-75.
13.Stifter S, Babarovic E, Valkovic T, Bekafigo IS, Stemberger C, Nacinovic A et al. Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma. Diagnostic Pathology 2010; 5: 30.
14.Diwan AG, Gandhi SA, Krishna K, Shinde VP. Clinical profile of the spectrum of multiple myeloma in a teaching hospital. Medical Jr. of Dr. D. Y. Patil University. 2014; 7(2): 185- 8
15.Rajkumar SV, Greipp PR. Prognostic factors in multiple myeloma. HaematolOncolClin North Am 1999; 13:1295.
16.Kapoor R, Bansal M, Sastri GJ, Sandhu MS, Garg M,Sharma SC.Clinical Spectrum and Prognosis of MultipleMyeloma in Patients Younger than 30 Years : Is it Different from the Elderly ?2006;8 ( 4): 225-228.
17.Guadarrama MBR, Medina CAM, Martinez EA. Plasma Cell Neoplasms, Clinicopathological Characteristics and Immunophenotype of 21 Patients. OJPathology. 2012; 2:127-132.
18.Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al. Review of 1027 Patients With Newly Diagnosed Multiple Myeloma. Mayo Clin Proc. 2003; 78: 21-23.
19.Haemoglobin concentrations for the diagnosis of anaemiaand assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.1)
Published
2017-10-25
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