| Multiple myeloma is a malignant plasma cell proliferative disease and accounts for 1% of all malignancies and slightly more than 10% of all hematologic malignancies. Since it affects many organs the signs and symptoms of myeloma as well as laboratory indicators vary greatly. Therefore, the research on clinical and laboratory diagnostic features of MM plays an important role in the early detection, early diagnosis, and differential diagnosis of MM.Method:Medical records of 169 in-patients from Changchun area were reviewed who were initially diagnosed with multiple myeloma at Jilin University First Hospital, Changchun from January 1,2004, to June 30,2010.Result:Among 169 newly diagnosed patients, the median age was 60 years (26-84 years). Seven patients were younger than 40 years, and 16.0%(27/169) were 70 years or older.40.8%(69/169) had IgG M-protein and 27.2%(46/169) had IgA. Eighty four percent (142/169) patients were in Durie-Salmon stage III. The major sign and symptoms at diagnosis were fatigue (100,59.2%), bone pain (96,56.8%) and weight loss (34,20.1%). Anemia was present initially in 94.0% (159/169), high erythrocyte sedimentation rate in 92.7%(101/109) and thrombocytopenia in 26.6%(45/169). Similarly, hypoalbuminemia, renal insufficiency and hypercalcemia were observed in 75.7%,27.8%, and 19.3% (31/161) respectively. Immunoparesis was found in 92.3%(156/169) of patients. Serum protein electrophoresis showed a localized band in 78.3%(123/157) of patients, and immunofixation detected monoclonal protein in 91.5%(139/152). Non-secretory myeloma was recognized in 4.1%(7/169) patients. Light chain myeloma was present in 22.5%(38/169) and these patients are more prone to develop renal insufficiency than the rest of myeloma patients (50% versus 21%, p<0.001). The bone marrow contained 10% or more plasma cells in 84.8% patients.Conclusion:(1) This study showed that the median age of onset of multiple myeloma was 60 years; earlier than in UK and the US.(2) Most of the patients were at advanced disease state (Durie-Salmon stageⅢ).(3) The common clinical sign and symptoms were bone pain, fatigue and anemia; half the patients had moderate anemia. Some patients were presented with hypoalbuminemia, renal insufficiency and hypercalcemia. Immunoparesis was present in about 92% patients.(4) There were many laboratory variables which aid in the diagnosis of MM. Among them immunofixation electrophoresis was the most important one and more sensitive than serum electrophoresis. Moreover, it not only detects M protein but also type of heavy and light chains of M protein.(5) Light chain myeloma patients were more prone to develop renal insufficiency than others (p<0.001). The patients in Durie-Salmon stage II and III had serumβ2-microglobulin more than 5.5 mg/1, an important laboratory indicator of disease progression and poor prognosis. |
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