Retrospective Analysis of Causes and Consequence of Delay in Diagnosis of Multiple Myeloma.

We have conducted a retrospective study of 82 patients (49 - male, 33 - female, median age 67 years (Male), 63 years (Female) ) of whom 72 were de novo and 10 had a previous diagnosis of MGUS/Smouldering myeloma/Plasmacytoma. The duration of symptoms prior to diagnosis was used to categorise patients into 4 groups [A - 0 - 3months, B - 3 -6 months, C - 6 - 12 months, D > 12 months]. The incidence of complications of myeloma (infection, renal failure, bone disease, neurological disease and anaemia) were assessed in each group. 25 of 72 patients (35%) were in group A, 47 (65%) were in group B,C and D and 30 of these (64%) had presented initially to a general practitioner. The commonest presenting symptom was bone pain (60%) and skeletal disease was the commonest complication seeing in 43% of group A but in 57% of groups B,C and D. All 18 patients in group D had > 1 complication (median 2, range 1–4) while 9 of 25 patients (35%) in group A had no complication. Four of 25 (16%) patients in group A were in remission or first phase of treatment and 7 of 25 (28%) had survived 5 years or more. In contrast, 9 of 18 (50%) patients in group D had relapsed disease and only 2 had survived 5 years or more. Our findings indicate that a delay in diagnosing multiple myeloma has a significant impact on the course of the disease.