Tumor Reduction in Multiple Myeloma: New Concepts for New Therapeutics

Paradigm shift in age of multiple myeloma patients: a study from a tertiary care government oncology hospital in Pakistan

PURPOSE

Multiple myeloma is a hematological disorder characterized by the presence of clonal plasma cells in the bone marrow that produce anemia, bone lesions, and kidney disease. The aim of this study was to determine the clinicopathological profile including age, sex, common symptoms and stage of patients with multiple myeloma diagnosed and managed in a government sector hospital in Pakistan.

PATIENTS AND METHODS

This retrospective cross-sectional study was conducted over a period of eight years at the Institute of Nuclear Medicine, Oncology, and Radiotherapy in Islamabad. Of the 89 patients diagnosed and treated in this hospital, 81 patients with complete data were included in the study.

RESULTS

Of the 81 patients, 55 were males and 27 were female patients. The mean age at diagnosis in our set of patients was 53 years, with 79% of the patients aged ≤ 60 years of age. The most common presenting symptom was bone pain followed by generalized fatigue and infections. The most common monoclonal gammopathy was IgG;12.3% patients were in stage I, 48.1% in stage II and 39.5% in stage III.

CONCLUSIONS

Our study revealed that the patients in our institution presented multiple myeloma at much younger age than the patients seen in developed countries of the world. Most studies from Pakistan present data from private sector hospitals. This is the first study conducted at a Pakistani government hospital in patients with multiple myeloma. More studies should be conducted representing patients from both private and government hospitals to understand the true magnitude of the disease and the factors behind this age difference in patients with multiple myeloma in our part of the world.

Clinical implications of measurable residual disease assessment in multiple myeloma in the era of quadruplet therapy

Multiple myeloma is a complex hematological malignancy with substantial heterogeneity in its clinical manifestations, biological processes, and patient outcomes. Although many biomarkers with have been identified to assist with disease monitoring and prognostication, predictive markers that inform treatment decisions remain elusive. As treatments become more effective, assays for measurable residual disease (MRD) below the level of detection of traditional assays have emerged as an essential component of disease assessment with powerful prognostic value for dynamic risk assessment. As its role as a potentially predictive biomarker continues to evolve, it is increasingly clear that MRD assessment has substantial clinical utility in the evaluation of patients with myeloma. In this review, we will summarize the evidence supporting the role of MRD as a prognostic biomarker and highlight the current clinical implications and future applications of MRD assessment in multiple myeloma.