Arch Iran Med. 2018;21(9):412-417.
PMID: 30221532
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Original Article

Retrospective Analysis of 345 Multiple Myeloma Cases: An Investigation from 2 Institutions

Hasan Jalaeikhoo 1, Morteza Sharifzadeh 1, Mohsen Rajaeinejad 1, Manoutchehr Keyhani 2, Mohammad Zokaasadi 1

1 AJA Cancer Epidemiology Research and Treatment Center (AJA- CERTC), AJA University of Medical Sciences, Tehran, Iran
2 Hematology and Oncology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Multiple myeloma (MM) accounts for a substantial mortality rate among hematological cancers. The prognosis of the disease has been noticeably changed during the past 2 decades. This study reports a retrospective analysis of 345 MM cases from 2 cancer centers.

Methods: Medical records of 345 MM cases were analyzed in retrospect. Diagnosis of MM was defined in presence of at least 10% plasma cells in bone marrow biopsy and one of the CRAB findings (hypercalcemia, renal failure, anemia and myeloma bone lesions). Survival analysis was performed using Kaplan-Meier method, and the effects of prognostic variables were assessed by Cox proportional hazards model.

Results: The mean age of the patients was 61.98 ± 11.44 years. Comparing to Mayo Clinic series, our patients were relatively younger and suffered from more advanced disease. By a median follow up time of 45 months, 1- and 5-year overall survival (OS) rates were 78.0% and 35.6%, respectively. Regarding first progression free survival (PFS1), similar rates of 57.7% and 17.0% were observed respectively. In multivariate analysis, hypercalcemia (corrected serum calcium >11 mg/dL), pancytopenia and elevated serum creatinine (Cr) (>2 mg/dL) were found to be independent prognostic factors affecting OS.

Conclusion: Presentation of MM in Iran which is a developing country, was significantly different from developed countries. This finding might be generalized to other developing countries as well. In addition, vincristine-adriamycin-dexamethasone (VAD) therapy was an inferior protocol compared to bortezomib as first and second lines. Furthermore, pancytopenia was observed in about 9% of the patients and was an independent prognosticator of the disease.

Cite this article as: Jalaeikhoo H, Sharifzadeh M, Rajaeinejad M, Keyhani M, Zokaasadi M. Retrospective analysis of 345 multiple myeloma cases: an investigation from 2 institutions. Arch Iran Med. 2018;21(9):412–417.
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Submitted: 13 Dec 2017
Accepted: 03 Jun 2018
First published online: 01 Sep 2018
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