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Multiple Myeloma-Clinicopathological Features and Risk Stratification

Objective: To evaluate the clinic pathological features and to risk stratify patients of multiple myeloma in our population. 
Study Design: Cross sectional study. 
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi Pakistan, from Jan to Jun 2019. 
Methodology: Patients that were newly diagnosed multiple myeloma on the basis of International Myeloma Working Group (IMWG) 2014 criteria were included in the study. Blood counts, peripheral film examination, bone marrow aspirate and trephine were examined. Biochemical profile, serum protein electrophoresis and skeletal survey was assessed. 
Results: A total of 65 newly diagnosed Multiple Myeloma patients were included. Of these, 43 (66.2%) were males and 22 (33.8%) females. Mean age of the patients was 58.5 years with a range of 36-76 years. The most common presenting symptom was bone pain in 33 (50.8%) patients, followed by backache in 32 (49.2%) patients. Mean percentage of plasma cell on bone marrow examination was 40.89% ± 23.2. On risk stratification based on International staging system, 20 (30.7%) patients were in stage I, 19 (29.1%) patients were on stage II while 26 (40.2%) patients were in stage III. 
Conclusion: Bone pain and backache along with anemia were found the predominant complaints of patients presenting with multiple myeloma in our setup with male predominance. Risk stratification of multiple myeloma according to ISS revealed that stage III was the most predominant in our population.