Original Article
Review of 1027 Patients With Newly Diagnosed Multiple Myeloma

https://doi.org/10.4065/78.1.21Get rights and content

Objective

To determine the clinical and laboratory features of newly diagnosed multiple myeloma.

Patients and Methods

Records of all patients in whom multiple myeloma was initially diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1985, to December 31, 1998, were reviewed.

Results

Of the 1027 study patients, 2% were younger than 40 years, and 38% were 70 years or older. The median age was 66 years. Anemia was present initially in 73% of patients, hypercalcemia (calcium level ≥11 mg/dL) in 13%, and a serum creatinine level of 2 mg/dL or more in 19%. The β2-microglobulin level was increased in 75%. Serum protein electrophoresis revealed a localized band in 82% of patients, and immunoelectrophoresis or immunofixation showed a monoclonal protein in 93%. A monoclonal light chain was found in the urine in 78%. Nonsecretory myeloma was recognized in 3% of patients, whereas light-chain myeloma was present in 20%. Conventional radiographs showed an abnormality in 79%. The plasma cell labeling index was 1% or more in 34% of patients. Multivariate analysis revealed that age, plasma cell labeling index, low platelet count, serum albumin value, and the log of the creatinine value were the most important prognostic factors.

Conclusion

The median duration of survival was 33 months and did not improve from 1985 through 1998.

Section snippets

PATIENTS AND METHODS

The records of all patients in whom multiple myeloma, plasmacytic myeloma, plasma cell myeloma, myelomatosis, or Kahler disease was initially diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1985, to December 31, 1998, were reviewed. The diagnosis of multiple myeloma was based on the following findings: (1) increased numbers of abnormal, atypical, or immature plasma cells in the bone marrow or histologic proof of plasmacytoma; (2) presence of an M-protein in the serum or urine;

RESULTS

Criteria for the diagnosis of multiple myeloma were fulfilled for 1027 patients seen at the Mayo Clinic in Rochester, Minn, from January 1, 1985, through December 31, 1998. Two percent of patients were younger than 40 years, and 38% were 70 years or older (Table 1); the median age was 66 years. Of these 1027 patients, 59% were men, 97% were white, and 1% were African American, a reflection of the ethnic composition of Mayo Clinic patients.

DISCUSSION

The age and sex distributions of the 1027 patients were similar to those of the 869 patients with multiple myeloma seen at the Mayo Clinic from 1960 to 19716 with respect to the median age and percentage of patients younger than 40 years. Only 1% were African American, but this rate is similar to the ethnic composition of Mayo Clinic patients. However, in the current study, 38% of patients were 70 years or older, compared with 23% in the earlier study. The incidence of multiple myeloma is much

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    This study was supported by grant CA62242 from the National Cancer Institute.

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