DOI QR코드

DOI QR Code

Clinicopathology Profile and Bone Involvement of Multiple Myeloma Patients in Dharmais National Cancer Hospital, Indonesia

  • Sutandyo, Noorwati (Division of Hematology-Medical Oncology, Dharmais National Cancer Hospital) ;
  • Firna, Evi (Division of Research and Development, Dharmais National Cancer Hospital) ;
  • Agustina, Julyanti (Division of Research and Development, Dharmais National Cancer Hospital) ;
  • Prayogo, Nugroho (Division of Hematology-Medical Oncology, Dharmais National Cancer Hospital) ;
  • Widjaja, Leovinna (Division of Research and Development, Dharmais National Cancer Hospital)
  • Published : 2015.10.06

Abstract

Background: Even though rarely found in Indonesia, the incidence of multiple myeloma (MM) is increasing every year. Bone involvement of MM is the most often a clinical disorder which leads to worsening clinical conditions and low quality of life of patients. Purpose: To determine the clinicopathology profile of bone involvement of MM patients in Indonesia. Materials and Methods: The cross-sectional study of MM conducted at Dharmais National Cancer Hospital (DNCH) by collecting data from medical records of MM patients who came to DNCH in period 2008-2012. Results: There were 39 MM patients all with age above 60 years. There were 56.4% male and 43.6% female patients. Most were diagnosed at stage III (32.4%), and 41% had obesity. The comorbid conditions were anemia (82.9%), hypoalbuminemia (60%), increased creatinine level (38.5%), increased ${\beta}2$ microglobulin level (94.1%), increased LDH level (23.1%) and plasmocytes above 30% (65%), but only 4.2% patients presented with hypercalcemia. Meanwhile, bone involvement occurred in 76.9% of MM patients with 4 lesions on average and a maximum of 16 lesions. The locations of bone lesions were spine (70%), skull (70%), pelvis (33.3%), humerus (30%), and femur (30%). Conclusions: The incidence of MM in Indonesia is increasing annually with bone involvement in more than three-fourths, but interestingly without hypercalcemia.

Keywords

Multiple myeloma;clinicopathology profile;bone involvement;Indonesia

References

  1. Alexander DD, Mink PJ, Adami HO, et al (2007). Multiple myeloma: A review of the epidemiologic literature. Int J Cancer, 120, 40-61. https://doi.org/10.1002/ijc.22718
  2. Blade J, Kyle RA, Greipp PR (1996). Presenting features and prognosis in 72 patients with multiple myeloma who were younger than 40 years. Br J Haematol, 93, 345-51. https://doi.org/10.1046/j.1365-2141.1996.5191061.x
  3. Brown LM, Gridley G, Pottern LM, et al (2001). Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control, 12, 117-25. https://doi.org/10.1023/A:1008937901586
  4. Chou T (2012). Multiple myeloma: recent progress in diagnosis and treatment. J Clin Exp Hematophatol, 52, 149-59. https://doi.org/10.3960/jslrt.52.149
  5. Ferlay J, Shin H, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  6. Friedman GD, Herrinton LJ (1994). Obesity and multiple myeloma. Cancer Causes Control, 5, 479-83. https://doi.org/10.1007/BF01694762
  7. Khan MMH, Mori M, Sakauchi F, et al (2006). Risk factors for multiple myeloma: evidence from the Japan collaborative cohort (JACC) study. Asian Pac J Cancer Prev, 7, 575-81.
  8. Kyle RA, Gertz MA, Witzig TE, et al (2003). Review of 1027 Clin Proc, 78, 21-33. https://doi.org/10.4065/78.1.21
  9. Lee JH, Lee DS, Lee JJ, et al (2010). Multiple myeloma in Korea: past, present, and future perspectives. Experience of the Korean multiple myeloma working party. Int J Hematol, 92, 52-7. https://doi.org/10.1007/s12185-010-0617-6
  10. NCCN Clinical Practice Guidelines in Oncology Guidelines [NNCN] (2015). Multiple myeloma versi 2. [online]. [cited on January 28th 2015] http://www.nccn.org/professionals/physician_gls/PDF/myeloma.pdf
  11. Oh SW, Yoon YS, Shin SA (2005). Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol, 23, 4742-54. https://doi.org/10.1200/JCO.2005.11.726
  12. Oyajobi BO (2007). Multiple myeloma/hypercalcemia. Arthritis Res Ther, 9, 4.
  13. Palumbo A, Anderson K (2011). Multiple myeloma. N Engl J Med, 364, 1046-60. https://doi.org/10.1056/NEJMra1011442
  14. Pan SY, Johnson KC, Ugnat AM, et al (2004). Association of obesity and cancer risk in Canada. Am J Epidemiol, 159, 259-68. https://doi.org/10.1093/aje/kwh041
  15. Pasqualetti P, Collacciani A, Maccarone C, et al (1996). Prognostic factors in multiple myeloma: selection using Cox's proportional hazard model. Biomed Pharmacother, 50, 29-35. https://doi.org/10.1016/0753-3322(96)85095-5
  16. Rajabli N, Naemi-Tabeie M, Jahangirrad A, et al (2013). Epidemiology of Leukemia and Multiple Myeloma in Golestan, Iran. Asian Pac J cancer Prev, 14, 2333-6. https://doi.org/10.7314/APJCP.2013.14.4.2333
  17. Saraf S, Patel P, Rondelli D (2012). Epidemiology, biology, and outcome in multiple myeloma patients in different geographical areas of the World. J Adv Intern Med, 1, 20-32.
  18. Scutellari PN, Orzincolo C, Bagni B, et al (1992). Bone disease in multiple myeloma. A study of 237 cases. Radiol Med, 83, 542-60.
  19. Shaheen H, Ghanghroo I, Malik I (1999). Clinicopathological features and management of Pakistani patients with multiple myeloma. J Pak Med Assoc, 49, 233-7.
  20. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics 2013. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  21. Sinuraya ES (2012a). Registrasi kanker berbasis rumah sakit di Rumah Sakit Kanker Dharmais 2003-2007. [The hospital based-cancer registry at dharmais cancer hospital 2003-2007]. Jakarta: Indonesian J Cancer, [Epub ahead of print].
  22. Sinuraya ES (2012b). Registrasi kanker berbasis rumah sakit di Rumah Sakit Kanker Dharmais 1993-1997. [The hospital based-cancer registry at dharmais cancer hospital 1993-1997]. Jakarta: Indonesian J Cancer, [Epub ahead of print].
  23. Sinuraya ES (In press). Data Registrasi Kanker Berbasis Populasi di Jakarta 2005-2007. The hospital based-cancer registry at Dharmais Cancer Hospital, [Epub ahead of print].

Cited by

  1. The Immunotyping Distribution of Serum Monoclonal Paraprotein and Environmental Impact on Multiple Myeloma (MM) and Monoclonal Gammopathy of Uncertain Significance (MGUS) in Taiwan: A Medical Center-Based Experience vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.395
  2. Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.1833
  3. International Scoring System in Symptomatic Multiple Myeloma: Experience from a Tertiary Care Center vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2031