Frequency and prognostic significance of hypercalcemia in patients with multiple myeloma

Abstract

Background: Multiple myeloma (MM) is defined as a clonal B-cell malignancy of the bone marrow. Hypercalcemia is associated with cancers in general and in MM specifically becomes more obvious with frequent adverse outcomes. Objectives: The objective is to determine the frequency of hypercalcemia in MM patients and survival rate after 3 years of diagnosis with the assessment of relationship between MM prognosis and hypercalcemia. Materials and Methods: Retrospective data were reviewed from the Hematology and Cancer Centers of Kurdistan Region of Iraq (KRI, Erbil, Sulaymaniyah, and Duhok) from January 2012 to December 2017 on a sample of 130 patients with MM. The diagnosis of MM and hypercalcemia was done according to the International Myeloma Working Group definition of MM and serum calcium of ≥11 mg/dl. Results: The prevalence of hypercalcemia among MM patients after calcium correction was 17.7%. Serum creatinine level is significantly higher among MM patients with hypercalcemia. There was a significant association between high death rates and MM patients with hypercalcemia. The mean survival of MM patients was 4.5 years and 72% of the MM patients had 3-year survival, which decreased to <41% for 6-year survival. The survival of MM patients with hypercalcemia was significantly shorter than survival of patients without hypercalcemia. Conclusions: The frequency of hypercalcemia among MM patients in KRI is within the international acceptable range and is regarded as a poor prognostic factor that is associated with higher mortality and shorter survival.

Keywords

• hypercalcemia
• multiple myeloma
• survival