Characterization of multiple myeloma at the University Teaching Hospital(UTH),Lusaka

Abstract

Context: Multiple myeloma (MM) is the second most common blood cancer after lymphomas, thereby accounting for 10% of all haematological malignancies. The incidence of MM is related to age with the condition being more common in the elderly. There is a higher incidence and mortality rate among blacks. Aims: To determine the biological and clinical characteristics of MM at the University Teaching Hospital in Lusaka, Zambia. Methods and Results: A descriptive study was done at the University Teaching Hospital in Lusaka, Zambia. Record files of 46 patients diagnosed with MM from 2008-2015 April were reviewed to determine the clinical and radiological features at presentation .The median age at diagnosis was 53.0 (range 32-81 years). From 46 patients, 25 (54%) were men and 21(46%) were females. The most frequent and common clinical, laboratory and radiological features in order of occurrence were osteolytic lesions, back ache, bone pain, anaemia, pathological fractures, chest pain and fatigue. Females had a higher proportion of fatigue than men with (P= 0.036). It was also observed that pathological fractures in individuals with osteolytic lesions were statistically significant with (P=0.001). Serum protein electrophoresis, immunofixation, complete blood count, Lactate dehydrogenase, urea, creatinine, albumin and calcium were assessed in only 15 patients as others died and were lost to follow up. Our results showed that the only types of MM present were IgG (80%) and IgA (20%). It was also observed that LDH and creatinine values were high, albumin and HB values were low and calcium, WBC, RBC, HCT and platelet values were normal. Conclusion: This study showed that IgG and IgA were the common isotype protein of MM in blood of patients presenting at UTH. The predominant light chain of the IgG and IgA was Kappa. It was further shown that osteolytic lesions which are a radiological feature of MM were the most frequent feature of patients presenting with MM at UTH, Lusaka Zambia.