(PA-428) Clinico-hematological and Cytogenetic Profile of Multiple Myeloma Patients in a North Indian Tertiary Care Hospital

Introduction:  Multiple myeloma (MM) is the 2nd most common hematological malignancy, relapsing and remitting in nature. Although treatments are evolving, MM remains incurable, with rapidly increasing incidence. Clinical presentation, molecular variability, and geographical and ethnic factors impact outcomes. This study aims to provide a clinico-hematological profile of MM patients at presentation in a tertiary care hospital in North India.  

Methods:   This retrospective cross-sectional study included 99 MM patients diagnosed between 2020 and 2024 at a North Indian tertiary care hospital. Data was collected from electronic medical records and analyzed using SPSSV20.2.

Results:   Among the 99 patients, 58 were male. The median age was 64 years (range 41–98). Symptoms at presentation included bone pain/fractures (38.4%), weakness (34.3%), and renal dysfunction (23.2%). Major comorbidities were hypertension (40.4%) and diabetes (25.3%). The median hemoglobin level was 9 g/dL (range 5–15.8 g/dL), with 86.8% having anemia. Hypercalcemia ( >10.3 g/dL) and hypocalcemia (< 8.4 g/dL) were noted in 10.2% and 25.3%, respectively. Lytic lesions were observed in 53.4% of 88 patients. Elevated LDH ( >246 IU/L) occurred in 21.5% of 65 patients. Peripheral blood smears predominantly showed normochromic normocytic anemia (59.6%). Bone marrow aspirates revealed >60% plasma cells in 28 patients. Elevated serum free light chain ratios ( >1.65) were observed in 56/84 patients. IgG κ was the most common M protein type (62.9%). FISH analysis (n=83) identified IGH rearrangements in 44.6%, monosomy in 45.8%, and any trisomy in 65.1% of patients. Translocations included t(11;14) (20.5%), t(4;14) (13.3%), and t(14;16) (3.6%). TP53 and RB1 deletions were observed in 12.0% and 7.2%, respectively.

Conclusions:   MM presents with diffuse symptomatology, necessitating a high level of suspicion for timely diagnosis. This study correlates clinical, laboratory, radiological, and cytogenetic findings, emphasizing bone pain, renal dysfunction, and high-risk genetic aberrations like TP53 deletion.Increased awareness of these features is crucial for early detection, enabling timely intervention to improve outcomes.