Multiple myeloma in Mexico: a 20-year experience at a single institution
Guillermo J Ruiz-Argüelles1, J David Gómez-Rangel, Guillermo J Ruiz-Delgado
1Centro de Hematología y Medicina Interna de Puebla, Calle 8B Sur 3710, 72530 Puebla, Mexico. gruiz1@clinicaruiz.com
Background:
In a 20-year period at a single institution, 66 cases of multiple myeloma (MM) were identified. The disease was less frequent in Mexico because in a multicenter study it represented 4.2% of all hematologic malignancies, whereas during this experience it was found to represent 7.7%. These figures contrast with those reported in Caucasians-10-15%.
Methods:
There were two patients <40 years of age; median age was 66 years. Bone pain was present in 54%, fatigue in 66%, and weight loss in 47%. Anemia was present in 75% of females and in 96% of males at diagnosis; median hemoglobin was 10.2 g/dL; abnormal monoclonal spike had a median of 2.87 g/dL (range 0-9.9). Four cases (6%) of nonsecretory myelomas were identified. Bence Jones proteinuria was present in 51 cases (77%). Forty six individuals were followed for >3 months (97-7,054 days, median 2,371 days).
Results:
Their survival (SV) was 51% at 540 days. Patients treated with melphalan/prednisone had a median SV of 33 months with a 72-month SV of 30%. Patients treated with vincristine/adriamycin/dexamethasone had an SV of 40% at 42 months, whereas those given high-dose chemotherapy and autologous stem cell rescue had an SV of 80% at 22 months.
Conclusions:
Clinical features of Mexican patients with MM were not significantly different from those reported for other populations; best results from treatment were observed in patients administered autologous stem cell transplantation.
