Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.
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Multiple Myeloma, Plasma Cell Neoplasm, Bone Pain, Lytic Lesions, Nepal
1. Introduction
Multiple myeloma (MM) is a clonal plasma cell malignancy characterized by the production of monoclonal immunoglobulin and associated end-organ damage, including osteolytic bone lesions, anemia, renal dysfunction, and hypercalcemia. It accounts for approximately 10% of all hematological malignancies worldwide and predominantly affects older adults. Advances in treatment strategies, including proteasome inhibitors, immunomodulatory drugs, and autologous stem cell transplantation, have significantly improved patient survival over the past two decades
[1]
Moritz DY. Multiple myeloma and other plasma cell diseases (Doctoral dissertation, Sveučilište u Zagrebu, Sveučilište u Zagrebu, Medicinski fakultet, Katedra za internu medicinu).
[1]
.
Despite therapeutic advances, MM remains largely incurable, with most patients experiencing disease relapse during the course of their illness
[2]
Bhatt P, Kloock C, Comenzo R. Relapsed/refractory multiple myeloma: a review of available therapies and clinical scenarios encountered in myeloma relapse. Current Oncology. 2023 Feb 15; 30(2): 2322-47.
[2]
. The clinical presentation and management of relapsed MM vary widely depending on disease biology, prior treatment exposure, and availability of diagnostic and therapeutic resources
[3]
Barlogie, B., Smallwood, L., Smith, T., & Alexanian, R. (1989). High serum levels of lactic dehydrogenase identify a high-grade lymphoma-like myeloma. Annals of internal medicine, 110(7), 521-525.
[3]
. In low- and middle-income countries, including Nepal, limited access to advanced diagnostics, novel agents, and transplant facilities may influence disease presentation and outcomes
[4]
Yanamandra U, Raphael C, Peela R, Saleh AJ, Dorji T, Juneh H, Gyi AA, Jha A, Mir MA, Somawardana B, Kabir AL. Treatment accessibility, availability, and healthcare costs for multiple myeloma in South Asian countries. Clinical Lymphoma Myeloma and Leukemia. 2025 Sep 3.
[4]
.
Data describing the clinic-pathological profile of MM patients from Nepal are limited. Understanding disease patterns, laboratory characteristics, and treatment practices is essential for clinical decision-making and resource allocation. This study aimed to describe the clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities among newly diagnosed patients with multiple myeloma treated at a tertiary care center in Nepal.
2. Materials and Methods
2.1. Study Design and Setting
This retrospective observational study was conducted at Vayodha Hospital, a tertiary care center in Nepal. Medical records of patients diagnosed with multiple myeloma between January 2023 and February 2025 were reviewed.
2.2. Study Population
Patients were included with confirmed diagnosis of multiple myeloma based on standard diagnostic criteria and received treatment. Patients with solitary plasmacytoma at initial diagnosis were excluded from analysis.
2.3. Data Collection
Demographic data, clinical presentation, laboratory investigations, radiological findings, serum immunofixation results, and treatment regimens were extracted from hospital records. Clinical features assessed included bone pain, fatigue, neurological symptoms, and renal impairment. Laboratory parameters included complete blood count, serum calcium, renal function tests, lactate dehydrogenase, beta-2 microglobulin, serum protein electrophoresis, serum immunofixation electrophoresis and light chain assay. Radiological evidence of lytic bone lesions was recorded.
2.4. Treatment Modalities
Treatment regimens were documented based on medical records and included bortezomib-based combinations, immunomodulatory drug–based regimens, conventional chemotherapy, radiotherapy, and supportive care. Autologous stem cell transplantation status was also reviewed.
2.5. Statistical Analysis
Data were analyzed using descriptive statistics. Categorical variables were expressed as frequencies and percentages. Continuous variables were summarized using ranges or proportions where applicable. Due to the small sample size, no inferential statistical analysis was performed.
2.6. Ethical Considerations
The study was conducted in accordance with the Declaration of Helsinki. Patient confidentiality was maintained by anonymizing all data. As this was a retrospective review of existing records, informed consent was waived according to institutional policy.
3. Results
3.1. Patient Demographics
A total of 21 patients were diagnosed with plasma cell neoplasm during the study period. Of these, three patients had solitary plasmacytoma of bone were excluded from the analysis. Among the remaining eighteen patients, males predominated (66.6%), with a male-to-female ratio of 2:1 (Table 1).
3.2. Clinical Presentation
Bone pain was the most common presenting symptom, reported by 90% of patients. Easy fatigability was observed in 39%. Neurological symptoms such as limb weakness, significant numbness, paresthesia, bladder and bowel involvement were present in 22%. Renal failure requiring dialysis was documented in one patient (5.5%). The distribution of clinical symptoms is summarized in Table 2.
3.3. Laboratory and Radiological Findings
Anemia was present in 61% of patients at presentation, while pancytopenia was observed in 11%. Elevated beta-2 microglobulin levels were detected in 78% of patients, and lactate dehydrogenase was raised in 67%. Hypercalcemia was noted in 11% of cases, and deranged renal function tests were observed in 22%. Radiological evidence of osteolytic bone lesions was present in 78% of patients. Monoclonal protein (M-band) was detected in 61% of cases on serum protein electrophoresis, summarized in Table 3.
3.4. Serum Immunofixation Profile
Serum immunofixation electrophoresis revealed IgG kappa as the most frequent monoclonal immunoglobulin subtype (55.5%), followed by IgG lambda (39%) and IgA kappa (5.5%). The distribution of monoclonal immunoglobulin subtypes is shown in Table 4.
3.5. Radiological Features
Radiology of the skeletal system revealed Lytic lesion in 78%, Compression fracture of the spine in 39% and Paraspinal mass in 17% which is summarized in Table 5.
3.6. Bone Marrow Study
Bone marrow aspiration and biopsy was done in all cases and increased plasma cells in the range of 30 to 60% was reported in 44%.
3.7. Treatment Modalities
The most commonly administered treatment regimen was Bortezomib, Lenalidomide, and Dexamethasone (VRD), used in 50% of patients. Lenalidomide plus dexamethasone was administered in 30% of cases. A smaller proportion received melphalan-based chemotherapy (6%). Two patients (11%) underwent autologous stem cell transplantation during the study period. Treatment patterns are summarized in Table 6.
Table 1. Gender distribution of patients with multiple myeloma included in the study.
Gender
Number of patients
Percentage (%)
Male
12
66.6
Female
6
33.3
Total
18
100
Table 2. Clinical symptoms at presentation among patients with relapsed multiple myeloma.
Clinical symptom
Percentage (%)
Bone pain
90.0
Easy fatigability
39.0
Neurological symptoms
22.0
Renal failure requiring dialysis
5.5
Table 3. Laboratory and radiological findings at presentation or relapse in patients with multiple myeloma.
Investigation
Percentage (%)
Anemia
61.0
Pancytopenia
11.0
Hypercalcemia
11.0
Deranged renal function tests
22.0
Raised lactate dehydrogenase
67.0
Raised beta-2 microglobulin
78.0
Lytic bone lesions
78.0
Presence of M-protein (M-band)
61.0
Table 4. Serum immunofixation electrophoresis profile showing distribution of monoclonal immunoglobulin subtypes.
Immunoglobulin subtype
Percentage (%)
IgG kappa
55.5
IgG lambda
39.0
IgA kappa
5.5
Table 5. Radiological Features.
Findings
Percentage (%)
Lytic lesion
78
Compression fracture
39
Paraspinal mass
17
Table 6. Treatment modalities administered to patients with relapsed multiple myeloma.
Treatment regimen
Percentage (%)
Bortezomib + Lenalidomide + Dexamethasone (VRD)
67.0
Lenalidomide + Dexamethasone
28.0
Melphalan + Prednisolone + Thalidomide
5.0
Autologous stem cell transplantation
11
4. Discussion
This study provides an overview of the clinico-pathological characteristics and treatment patterns of patients with multiple myeloma treated at a tertiary care center in Nepal. Consistent with existing literature, MM predominantly affected males and commonly presented with bone pain and anemia, reflecting extensive skeletal and marrow involvement
Diwan et al., documented that sixth decade is the common age of presentation with a mean of 62 years
[6]
Diwan, A. G., Gandhi, S. A., Krishna, K., & Shinde, V. P. (2014). Clinical profile of the spectrum of multiple myeloma in a teaching hospital. Medical Journal of Dr. DY Patil University, 7(2), 185-188.
[6]
. Rajkumar and Kyle et al et al. documented that the mean age of presentation was 66 years with 2% younger than 40 and 38% older than 70 years
[7]
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15(12): e538–e548.
[8]
Kyle RA, Rajkumar SV. Multiple myeloma. Blood. 2008; 111(6): 2962–2972.
[7, 8]
. Kumar et al., from India reported that the median age of 55 years and male: female ratio 1.5:1
[9]
Kumar SK, Callander NS, Adekola K, et al. Multiple myeloma, version 3.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2020; 18(12): 1685–1717.
[9]
. Median age of 62 years with 55.6% of male predominance was reported from Asian study by Kim et al.
[13]
Kim K, Lee JH, Kim JS, Min CK, Yoon SS, Shimizu K, Chou T, Kosugi H, Suzuki K, Chen W, Hou J. Clinical profiles of multiple myeloma in Asia—An Asian Myeloma Network study. American journal of hematology. 2014 Jul;89(7):751-6.
[13]
. Our study showed M: F ratio 2:1 and median age of 56 years.
Barlogie et al. showed mean hemoglobin level >8.5 g/dL
[3]
Barlogie, B., Smallwood, L., Smith, T., & Alexanian, R. (1989). High serum levels of lactic dehydrogenase identify a high-grade lymphoma-like myeloma. Annals of internal medicine, 110(7), 521-525.
[3]
. Diwan AG et al found anemia in 100%, and Zafar et al. found anemia in 80% of patients
[6]
Diwan, A. G., Gandhi, S. A., Krishna, K., & Shinde, V. P. (2014). Clinical profile of the spectrum of multiple myeloma in a teaching hospital. Medical Journal of Dr. DY Patil University, 7(2), 185-188.
[10]
Zafar, M. S. H., Dar, M. A., & Sofi, M. A. (2023). Clinicobiochemical profile in de novo multiple myeloma: A study from North India. Asian Journal of Medical Sciences, 14(11), 108-111.
[6,10]
. In our study anemia was documented in 61%. Ramani et al. showed serum creatinine level >2 mg/dL in 30% and hypercalcemia in 5% of cases
[11]
Sreeraj V, Binub K. Clinical profile of multiple myeloma in a tertiary medical college northern Kerala, India. IP International Journal of Medical Paediatrics and Oncology. 2023 Jan 22; 5(2): 58-61.
[11]
. Zafar et al reported renal failure in 44% in their series. In our study renal impairment and hypercalcemia was found in 22% and 11% respectively.
The high prevalence of elevated beta-2 microglobulin and lytic bone lesions suggests advanced disease at presentation or relapse. In the present study “M” band was detected in 61% while study by Ramani et al reported 78% in their series. Study from India by Zafar et al. found IgG-λ type MM in 32% followed by IgG-k in 20%
[10]
Zafar, M. S. H., Dar, M. A., & Sofi, M. A. (2023). Clinicobiochemical profile in de novo multiple myeloma: A study from North India. Asian Journal of Medical Sciences, 14(11), 108-111.
[10]
. In present study, IgG kappa was the predominant immunoglobulin sub type in 55.5% followed by IgG-λ in 39%.
In our study, osteolytic lesion was found in 78% and compression fracture in 39% cases. In study from India by Ramani et al reported lytic lesion in 85% and pathological fracture in 35% of cases. In the study by Diwan et al reported osteolytic lesion in 91%.
Bortezomib-based regimens formed the backbone of treatment, however, was adopted by 67% of patients only because of financial constraint. All Patients received Zoledronic acid as parenteral Bisphosphonate for bone disease as drug is easily available, cost effective and recommended by IMWG
[12]
Terpos E, Morgan G, Dimopoulos MA, et al. IMWG recommendations for the treatment of multiple myeloma-related bone disease. J Clin Oncol. 2013; 31(18): 2347–2357.
[12]
. Lenalidomide based doublet was opted by 28% and Melphalan based (MPT regimen) was offered to one patient in the present series. In the study by Cheong et al from Malaysia reported triplet regimen used in 59% and doublet in 41% as induction therapy in their study
[14]
Cheong CS, Aziz TA, Anuar NA, Bee PC, Chin EF, Khairullah S, Liong CC, Zamri Y, Gan GG. Treatment Pattern and Outcome of Newly Diagnosed Multiple Myeloma Patients in a Resource-Limited Setting. Asian Pacific journal of cancer prevention: APJCP. 2024; 25(2): 595.
[14]
. Two patients underwent autologous bone marrow transplant after achieving complete remission by Bortezomib based triplet regimen. Most common first line therapy used was Bortezomib, Cyclophosphamide and Dexamethasone in 77% of patients reported by Mishra et al in their study from India
[15]
Mishra D, Nair A, Shah J, Saha S, Nayak L, Shetty A, Tembhare P, Khan A, Jindal N, Mirgh S, Gokarn A. Attrition Rates in Multiple Myeloma-A Report from indian Patients at A Tertiary Cancer Center. Indian Journal of Hematology and Blood Transfusion. 2025 Dec 5: 1-8.
[15]
. After four months of induction, disease re-assessment was done by hematological, biochemical parameters including bone marrow examination and based on response two more cycles of consolidation were given and followed by continuation of maintenance. Modalities of treatment are basically dependent on financial resources and adherence to close follow up. However, access to autologous stem cell transplantation and newer therapeutic agents remained limited, which may influence long-term disease control and survival outcomes.
The study is limited by its retrospective design, small sample size, and single-center setting which may restrict generalizability. Additionally, survival outcomes and cytogenetic risk stratification could not be evaluated due to incomplete data and financial constraint. Despite these limitations, the findings highlight the heterogeneity of MM presentation and underscore the challenges of managing disease in resource-constrained settings.
5. Conclusion
Multiple myeloma in this Nepalese cohort demonstrated heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, elevated beta-2 microglobulin levels, and lytic bone lesions were the most frequent findings at presentation or relapse. IgG kappa was the predominant immunoglobulin subtype, consistent with global patterns.
Bortezomib-based regimens constituted the mainstay of treatment; however, access to autologous stem cell transplantation and newer therapeutic agents was limited. These constraints may influence disease control and long-term outcomes. The findings highlight the need for improved diagnostic capacity, wider availability of advanced therapies, and development of context-specific treatment strategies to optimize multiple myeloma care in resource-limited settings such as Nepal.
Moritz DY. Multiple myeloma and other plasma cell diseases (Doctoral dissertation, Sveučilište u Zagrebu, Sveučilište u Zagrebu, Medicinski fakultet, Katedra za internu medicinu).
[2]
Bhatt P, Kloock C, Comenzo R. Relapsed/refractory multiple myeloma: a review of available therapies and clinical scenarios encountered in myeloma relapse. Current Oncology. 2023 Feb 15; 30(2): 2322-47.
[3]
Barlogie, B., Smallwood, L., Smith, T., & Alexanian, R. (1989). High serum levels of lactic dehydrogenase identify a high-grade lymphoma-like myeloma. Annals of internal medicine, 110(7), 521-525.
[4]
Yanamandra U, Raphael C, Peela R, Saleh AJ, Dorji T, Juneh H, Gyi AA, Jha A, Mir MA, Somawardana B, Kabir AL. Treatment accessibility, availability, and healthcare costs for multiple myeloma in South Asian countries. Clinical Lymphoma Myeloma and Leukemia. 2025 Sep 3.
Diwan, A. G., Gandhi, S. A., Krishna, K., & Shinde, V. P. (2014). Clinical profile of the spectrum of multiple myeloma in a teaching hospital. Medical Journal of Dr. DY Patil University, 7(2), 185-188.
[7]
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15(12): e538–e548.
[8]
Kyle RA, Rajkumar SV. Multiple myeloma. Blood. 2008; 111(6): 2962–2972.
[9]
Kumar SK, Callander NS, Adekola K, et al. Multiple myeloma, version 3.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2020; 18(12): 1685–1717.
[10]
Zafar, M. S. H., Dar, M. A., & Sofi, M. A. (2023). Clinicobiochemical profile in de novo multiple myeloma: A study from North India. Asian Journal of Medical Sciences, 14(11), 108-111.
[11]
Sreeraj V, Binub K. Clinical profile of multiple myeloma in a tertiary medical college northern Kerala, India. IP International Journal of Medical Paediatrics and Oncology. 2023 Jan 22; 5(2): 58-61.
[12]
Terpos E, Morgan G, Dimopoulos MA, et al. IMWG recommendations for the treatment of multiple myeloma-related bone disease. J Clin Oncol. 2013; 31(18): 2347–2357.
[13]
Kim K, Lee JH, Kim JS, Min CK, Yoon SS, Shimizu K, Chou T, Kosugi H, Suzuki K, Chen W, Hou J. Clinical profiles of multiple myeloma in Asia—An Asian Myeloma Network study. American journal of hematology. 2014 Jul;89(7):751-6.
[14]
Cheong CS, Aziz TA, Anuar NA, Bee PC, Chin EF, Khairullah S, Liong CC, Zamri Y, Gan GG. Treatment Pattern and Outcome of Newly Diagnosed Multiple Myeloma Patients in a Resource-Limited Setting. Asian Pacific journal of cancer prevention: APJCP. 2024; 25(2): 595.
[15]
Mishra D, Nair A, Shah J, Saha S, Nayak L, Shetty A, Tembhare P, Khan A, Jindal N, Mirgh S, Gokarn A. Attrition Rates in Multiple Myeloma-A Report from indian Patients at A Tertiary Cancer Center. Indian Journal of Hematology and Blood Transfusion. 2025 Dec 5: 1-8.
Jha, A. K., Subedi, G., Sinha, A. K. (2026). Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. International Journal of Clinical and Experimental Medical Sciences, 12(2), 34-38. https://doi.org/10.11648/j.ijcems.20261202.12
Jha, A. K.; Subedi, G.; Sinha, A. K. Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. Int. J. Clin. Exp. Med. Sci.2026, 12(2), 34-38. doi: 10.11648/j.ijcems.20261202.12
Jha AK, Subedi G, Sinha AK. Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. Int J Clin Exp Med Sci. 2026;12(2):34-38. doi: 10.11648/j.ijcems.20261202.12
@article{10.11648/j.ijcems.20261202.12,
author = {Ajaya Kumar Jha and Garima Subedi and Arvind Kumar Sinha},
title = {Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal},
journal = {International Journal of Clinical and Experimental Medical Sciences},
volume = {12},
number = {2},
pages = {34-38},
doi = {10.11648/j.ijcems.20261202.12},
url = {https://doi.org/10.11648/j.ijcems.20261202.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20261202.12},
abstract = {Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.},
year = {2026}
}
TY - JOUR
T1 - Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal
AU - Ajaya Kumar Jha
AU - Garima Subedi
AU - Arvind Kumar Sinha
Y1 - 2026/07/17
PY - 2026
N1 - https://doi.org/10.11648/j.ijcems.20261202.12
DO - 10.11648/j.ijcems.20261202.12
T2 - International Journal of Clinical and Experimental Medical Sciences
JF - International Journal of Clinical and Experimental Medical Sciences
JO - International Journal of Clinical and Experimental Medical Sciences
SP - 34
EP - 38
PB - Science Publishing Group
SN - 2469-8032
UR - https://doi.org/10.11648/j.ijcems.20261202.12
AB - Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.
VL - 12
IS - 2
ER -
Jha, A. K., Subedi, G., Sinha, A. K. (2026). Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. International Journal of Clinical and Experimental Medical Sciences, 12(2), 34-38. https://doi.org/10.11648/j.ijcems.20261202.12
Jha, A. K.; Subedi, G.; Sinha, A. K. Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. Int. J. Clin. Exp. Med. Sci.2026, 12(2), 34-38. doi: 10.11648/j.ijcems.20261202.12
Jha AK, Subedi G, Sinha AK. Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal. Int J Clin Exp Med Sci. 2026;12(2):34-38. doi: 10.11648/j.ijcems.20261202.12
@article{10.11648/j.ijcems.20261202.12,
author = {Ajaya Kumar Jha and Garima Subedi and Arvind Kumar Sinha},
title = {Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal},
journal = {International Journal of Clinical and Experimental Medical Sciences},
volume = {12},
number = {2},
pages = {34-38},
doi = {10.11648/j.ijcems.20261202.12},
url = {https://doi.org/10.11648/j.ijcems.20261202.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20261202.12},
abstract = {Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.},
year = {2026}
}
TY - JOUR
T1 - Clinico-Pathological Profile of Multiple Myeloma:
A Single-Center Study from Nepal
AU - Ajaya Kumar Jha
AU - Garima Subedi
AU - Arvind Kumar Sinha
Y1 - 2026/07/17
PY - 2026
N1 - https://doi.org/10.11648/j.ijcems.20261202.12
DO - 10.11648/j.ijcems.20261202.12
T2 - International Journal of Clinical and Experimental Medical Sciences
JF - International Journal of Clinical and Experimental Medical Sciences
JO - International Journal of Clinical and Experimental Medical Sciences
SP - 34
EP - 38
PB - Science Publishing Group
SN - 2469-8032
UR - https://doi.org/10.11648/j.ijcems.20261202.12
AB - Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.
VL - 12
IS - 2
ER -
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