A Review of 74 Patients with Newly Diagnosed Multiple Myeloma at A Tertiary Referral Hospital in Nairobi, Kenya

Abstract

Introduction Multiple myeloma is a neoplastic disorder characterized by clonal proliferation of plasma cells. We aimed to carry out a retrospective audit to describe clinical and laboratory features of patients newly diagnosed with multiple myeloma.

Materials and Methods Records of all patients initially diagnosed with multiple myeloma at the haematology clinic of Aga Khan University Hospital, Nairobi, from January 1, 1999 to December 31, 2011 were reviewed. Diagnosis of multiple myeloma was based on (1) increased numbers of abnormal, atypical or immature plasma cells in a bone marrow aspirate or trephine, (2) presence of monoclonal protein or free light chains in serum or urine and (3) bone lesions consistent with multiple myeloma.

Results Seventy-four patients were diagnosed with multiple myeloma. The median age at diagnosis was 59 years. Males comprised 53%. The most common presenting complaints were bone pain in 56 (76%), recurrent infections in 11 (16%) and fatigue in 24 (33%) patients. Anaemia (Hb < 10 g/dl) was present at diagnosis in 47% of patients while 25 (34%) presented with hypercalcaemia (serum calcium > 2.6 mmol/l) and 38 patients (52%) had renal failure at diagnosis (serum creatinine > 110μmol/l). A monoclonal band was demonstrated in 56 patients (76%). Nine patients (12%) had light chain myeloma while only 4 patients had nonsecretory myeloma. One patient was found to have biclonal myeloma.

Conclusion The median age of patients at diagnosis is lower than that reported in other populations [59 years versus 66–68 years] and may indicate a younger age of incidence of the pre-malignant monoclonal gammopathy of undetermined significance (MGUS) in African patients.