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Year : 2020  |  Volume : 11  |  Issue : 3  |  Page : 149-152

Impact of delayed diagnosis of multiple myeloma

Department of Adult Hematology/Oncology, King Saud Medical City, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Assem Elghazaly
Department of Adult Hematology/Oncology, King Saud Medical City, Ulisha Street, Postal Code 7790, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joah.joah_90_19

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BACKGROUND: Multiple myeloma (MM) is a malignant neoplasm of plasma cells. It constitutes about 1% of the entire human malignancies. The disease affects multiple body systems/organs including the kidneys, bone, hematopoiesis, and immune system. Delay in diagnosis, with a negative impact on patients' outcome particularly those with emergency presentation, had been reported. No local publication had addressed this issue. The aim of this work is to study the local practice, specifically the time from initial symptoms to the diagnosis of MM. METHODS: This is a medical record-based study from a central hospital, Saudi Arabia. The study included all newly diagnosed patients with MM from June 2016 to January 2019. RESULTS: A total of 22 patients were studied, of them 21 presented to our hospital emergency room with nonspecific symptoms, before the diagnosis was made for the first time. All the patients had prior visits to other clinics/centers without a definitive diagnosis reached. Back pain was the most common initial symptom. We demonstrated more frequent disease-related complications, particularly end-stage renal disease requiring hemodialysis (27%) at the time of diagnosis than that mentioned in other studies. The median time from initial symptoms to diagnosis was 204 days, which is longer than what had been shown in previous reports. CONCLUSIONS: Delayed diagnosis of MM, with its negative impact on patients' outcome, is a challenge. In our center experience, most patients had significate disease-related complications at the time of diagnosis. Raising the awareness about red flags of back/bone pain as well as having an effective referral pathway is suggested.

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