Cross-sectional study of 100 cases of newly diagnosed plasma cell neoplasms in a tertiary care setup

The aim of the study was to evaluate the clinical and laboratory profile of newly diagnosed cases of Multiple myeloma (MM) in a tertiary care hospital in western India. Records of all the patients who were diagnosed as MM was taken out from the archives from September 2013 to February 2021 and analyzed for various parameters. Of the 100 patients studied, 3% were below the age of 40 years with most of the cases in the 6 th and 7 th decade. The mean age of the study was 61.98 years. The most common symptoms were low backache (LBA), bone pains and easy fatigability. Anemia was present at the outset in 67% of cases, hypercalcemia in 12% of cases, renal impairment in 22% of cases, raised lactate dehydrogenase (LDH) in 18% of cases and raised β 2- microglobulin levels in 48% of cases. 37% of cases showed reversal of albumin:globulin (A:G) ratio. Bone marrow (BM) plasma cells (PC) ranged from 12 to 90% on myelogram. There was a detectable ‘monoclonal’ (M) spike in 77% of cases on serum protein electrophoresis whereas immunofixation revealed a monoclonal protein in 92% of cases. Osteolytic lesions were found in 64% of cases. Cytogenetic analysis showed cases to be harbouring del 13q, t(11;14), del 17p, immunoglobulin heavy chain (IGH) rearrangement and t(4;14). Most patients received a combination of the standard regimes of Bortezomib-Lenalidomide-Dexamethasone and the response was assessed at the end of each cycle. Plasma Cell Neoplasms (PCN) present with varied symptomatology and hence an extremely high index of suspicion is required for early diagnosis and prompt management.