International Journal of Scientific Reports | May 2021 | Vol 7 | Issue 5 Page 270
International Journal of Scientific Reports
Oliveira FPA et al. Int J Sci Rep. 2021 May;7(5):270-276
http://www.sci-rep.com
pISSN 2454-2156 | eISSN 2454-2164
Original Research Article
Prognostic factors in multiple myeloma and
the impact of the bone involvement
Flora Palmari Audi Oliveira
1
, Vitória Melina Faquini de Souza
1
,
Maura Lima Pereira Bueno
1,2
*, Fernanda Marconi Roversi
1,2
INTRODUCTION
Multiple myeloma (MM) is an incurable however
treatable hematologic malignancy in which plasmocytes
(activated B lymphocytes) abnormally proliferate in bone
marrow, usually resulting in an oversecretion of an
antibody known as monoclonal immunoglobulin or
monoclonal protein (M-protein), which can be easily
measured in the blood or in urine.
1,2
Intensive plasmocyte
growth in the bone marrow can crowd out normal blood-
forming cells, leading to low blood cells counts and result
in anemia, thrombocytopenia and leukopenia.
3,4
Thus, the
patient could present tiredness and weakness, increased
bleeding and bruising, along with impaired ability to a
normal immune response. In addition, MM patients are
usually affected by bone pain caused by the infiltration of
ABSTRACT
Background: Multiple myeloma is characterized by abnormal plasmocytes proliferation in the bone marrow,
resulting in an immunoglobulin oversecretion, which can cause bone pain, anemia, kidney dysfunction, and
infections. The present study evaluates prognostic factors and the bone involvement in patients who had a confirmed
diagnosis of MM.
Methods: A retrospective study was conducted in hospital universitário São Francisco of Bragança Paulista. Patient
demographic data, laboratory parameters and treatment received were recorded. We also analyzed the variables
related to diagnosis and the development of bone lesions in MM patients.
Results: A total of 42 patients had a confirmed diagnosis of MM, out of which most (54.76%) were older than 65.
Most patients (45.24%) had beta-2-microglobulin values greater than 5.5 mcg/dl, indicating an advanced stage of the
disease and consequently a less favorable prognosis. The main clinical manifestation observed was anemia in 61.90%
(26/42) and bone lesions 59.52% (25/42). The analysis of imaging exams showed that most patients presented bone
alterations, such as osteopenia, lytic lesions and fractures. Interestingly, 11.90% patients were submitted to
autologous bone marrow transplantation with further remission of the disease. Bone marrow transplantation increases
overall survival and disease-free survival when compared to conventional treatment.
Conclusions: Since MM prognostic factors are numerous and, therefore, the understanding and analysis of the
clinical and laboratory features of MM can contribute to an early diagnosis of patients, a targeted therapeutic
approach and better outcomes.
Keywords: Multiple myeloma, Hematological malignancy, Bone involvement
1
Universidade São Francisco, Bragança Paulista, São Paulo, Brazil
2
Hematology and Transfusion Medicine Center, University of Campinas/Hemocentro-Unicamp, Campinas, São Paulo,
Brazil
Received: 12 January 2021
Revised: 05 April 2021
Accepted: 06 April 2021
*Correspondence:
Dr. Maura Lima Pereira Bueno,
E-mail: mauralimabueno@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20211455