Review of 1027 patients with newly diagnosed multiple myeloma.
OBJECTIVE
To determine the clinical and laboratory features of newly diagnosed multiple myeloma.


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 > or = 11 mg/dL) in 13%, and a serum creatinine level of 2 mg/dL or more in 19%. The beta2-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.


CONCLUSIONS
The median duration of survival was 33 months and did not improve from 1985 through 1998.
Kyle
Robert A
RA
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA. kyle.robert@mayo.edu
Gertz
Morie A
MA
Witzig
Thomas E
TE
Lust
John A
JA
Lacy
Martha Q
MQ
Dispenzieri
Angela
A
Fonseca
Rafael
R
Rajkumar
S Vincent
SV
Offord
Janice R
JR
Larson
Dirk R
DR
Plevak
Matthew E
ME
Therneau
Terry M
TM
Greipp
Philip R
PR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D001797:Blood Protein Electrophoresis; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D007122:Immunoelectrophoresis; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D015999:Multivariate Analysis; D010265:Paraproteinemias / Q000175:diagnosis; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D016019:Survival Analysis
D012709:Serum Albumin; D003404:Creatinine