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Changing clinical presentation of multiple myeloma
A Riccardi1, P G Gobbi, G Ucci
1Dipartimento di Medicina Interna e Terapia Medica, Università di Pavia, Italy.
European Journal of Cancer (Oxford, England : 1990)
|January 1, 1991
Summary
Multiple myeloma patients are now diagnosed earlier, presenting with fewer symptoms like bone pain and renal failure. This shift towards earlier detection means more asymptomatic cases are found incidentally.
Area of Science:
- Hematology
- Oncology
- Clinical Medicine
Background:
- Multiple myeloma presentation has evolved over decades.
- Understanding these changes is crucial for interpreting survival data.
Purpose of the Study:
- To compare the clinical presentation of multiple myeloma across different diagnostic eras.
- To identify trends in symptom prevalence and disease indicators over time.
Main Methods:
- Retrospective analysis of three patient cohorts diagnosed between 1960-1971, 1972-1986, and 1987-1990.
- Comparison of symptom frequency, bone disease, renal function, and laboratory abnormalities.
Main Results:
- A significant decrease in symptomatic multiple myeloma diagnoses (90% to 66%) and an increase in asymptomatic, incidentally diagnosed cases (14% to 34%) were observed in recent cohorts.
- Later diagnosed patients showed reduced bone pain (68% to 37%), less advanced bone disease, and lower incidences of renal failure, hypercalcemia, and hyperuricemia.
- Systemic symptoms, including anemia, leukopenia, and thrombocytopenia, were less frequent in more recently diagnosed patients.
Conclusions:
- Multiple myeloma diagnosis is occurring earlier in its disease course.
- The declining prevalence of overt symptoms and complications at diagnosis necessitates adjustments when comparing historical and contemporary survival statistics.