[Who refer patients with multiple myeloma to hematology-oncology: A retrospective study at Hôtel-Dieu de France]

Multiple myeloma presents with a wide spectrum of symptoms that may initially direct patients to different medical specialties. This study aims to identify the specialties that most frequently refer newly diagnosed patients to hemato-oncology.

A retrospective study was conducted using the medical records of adult patients diagnosed with multiple myeloma at the Hôtel-Dieu de France University Hospital between 2013 and 2024. Collected data included the referring specialty, age, sex, isotypes, percentage of bone marrow plasma cells, prognostic factors, the Revised International Staging System, initial symptoms, and therapeutic modalities.

Two hundred patients were included, comprising 120 men and 80 women, with a median age at diagnosis of 68 and 64 years, respectively. Among patients referred by a specialty (88%), orthopedic surgeons were the main referring physicians (19.3%), followed by nephrologists (17.6%), rheumatologists (10.2%), and cardiologists (8.5%). Patients referred by surgical specialties were more frequently diagnosed at an early stage I (P<0.001), whereas those referred by medical specialties more often presented with stage II or III disease.

Multiple myeloma is frequently diagnosed outside hemato-oncology. The predominance of orthopedic referrals reflects the high frequency of bone involvement, favoring earlier diagnosis. In contrast, medical specialties are associated with more advanced stages, related to later systemic manifestations. This highlights the importance of clinical vigilance and multidisciplinary collaboration to improve early detection.