title: International Scoring System in Symptomatic Multiple Myeloma: Experience from a Tertiary Care Center.
abstract: BACKGROUND
  Symptomatic multiple myeloma (MM) is an acquired B-cell malignant proliferation of anti- body secreting plasma cells, characterized by end organ damage due to monoclonal immunoglobulin secretion. The aim of this study wa to determine the stage stratification according to an international scoring system in adult Pakistani MM patients at presentation.
  
  
  METHODS
  This single centre retrospective study extendedfrom January 2012 to December 2015. Data were retrieved from the departmental maintained records.
  
  
  RESULTS
  A total of 39 patients were diagnosed at our center with MM during the period of the study, 25 males and 14 females. Age ranged between 36 and 81 with a mean of 54.5±14.8 and a median of 57 years. Common presenting complaints included fatigue (80.9%), backache (79.3%) and bone pain (66.2%). Overall, 9 patients were in ISS stage I (23%), 12 were in stage II (30.7%) and 18 were in stage III (46.1%). Out of the total, 29 (74.3%) had kappa immunoglobulin andthe remaining 10 (25.6%) had lambda type myelomas. IgG myeloma was commonest, seen in 26 (66.6%) followed by IgA in 11 (28.2%) with non secretory myeloma in one (2.5%) and light chain disease also in one patient (2.5%).
  
  
  CONCLUSIONS
  MM in Pakistani patients is seen in a relatively young population with male predominance. Primarily patients are symptomatic and risk stratification revealed a predominance of advanced stage III disease in our setting.
authors.affiliation: Department of Hematology and Blood bank, Liaquat National Hospital and Medical College, Karachi, Pakistan, E-mail : sadiasultan96@yahoo.com.
authors.forename: Sadia
authors.initials: S
authors.lastname: Sultan
authors.forename: Syed Mohammed
authors.initials: SM
authors.lastname: Irfan
authors.forename: Saira
authors.initials: S
authors.lastname: Parveen
authors.forename: Ufaq
authors.initials: U
authors.lastname: Taufiq
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000097:blood*; D007390:International Agencies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000473:pathology*; D009194:Myeloma Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D014408:Biomarkers, Tumor; D007145:Immunoglobulin kappa-Chains; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins