Spectrum of Bone Complications in Newly diagnosed Multiple Myeloma patients

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Abstract Multiple myeloma is a malignant disorder of plasma cells that seed throughout the bone marrow and usually produce a monoclonal immunoglobulin in the blood, urine, or both, cause lytic bone lesions. A total of 159 newly diagnosed multiple myeloma patients aged 24 to 85 were included in this study. The median age of 159 patients was 56 years. Highest incidence of multiple myeloma was found in 50-59 years age group and P value was statistically significant. Male patient was 103 (65%) and female patient was 56 (35%). The median age of male patients was 56 years and the female patients was 57 years. There was no statistically significant age difference between male and female patients. 76.1% patients had bone involvement. Lytic bone lesions were found in 45.9% cases. Among them 15.1% patient had single lytic lesion and 30.8% patient had multiple lytic lesions. Most common site of lytic lesion was skull (33.3%).Pelvis was the second most common site of lytic lesion (15.7%).The prevalence of fracture was 44.7%, among them vertebral fracture was in 37.1% cases, rib fracture was in 9.4% cases, humerus fracture was in 3.1%, femur fracture was in 3.8%, fracture of neck of femur in 0.6%. Nerve root compression found in 12.6% cases. Lytic lesion and fracture are most common features of bone involvement in multiple myeloma patients. MRI study instead of radiographic study may increase the detection of bone lesion especially in the thoraco-lumber spine, pelvis and proximal femurs. Further studies incorporating MRI study are necessary to determine skeletal changes of MM patients.

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