P-47 Clinico-radiological profile of patients with myelomarelated skeletal events at a tertiary institution: a retrospective analysis from 2014 -2018
Author(s):
J Foote, G Wharfe
Year of Presentation:
2023
Objective: This study sought to determine the prevalence of skeletal-related events in patients with multiple myeloma at the University Hospital of the West Indies between 2014- 2018 and to describe their characteristics.
Methods: A cross-sectional retrospective design was used, and 116 patients were eligible. Eligibility included newly registered patients aged 18 years and older patients who were being investigated for a plasma cell disorder between 2014 and 2018. Data was collected to review the type of monoclonal gammopathy, the number of patients with related bone disease, the type of skeletal event and the number of patients with negative surveys that received additional radiological testing.
Results: Multiple Myeloma was commonest diagnosis (n=67, 57%, P<0.05). Only 1 patient (1%, P<0.05) was diagnosed with smoldering myeloma, and 2% (n=2, P<0.05) with plasma cell leukemia. The mean (sd) age 62.81 (11.9) years. For the profile of skeletal events 11%, (n= 5, P<0.05) had lytic lesions, 7% (n = 8, P<0.05) compression fracture, 2% (n=2, P<0.05) plasmacytoma, 1%, (n=1, P<0.05) had a mildly displaced fracture. MRIs detected 9% (n=11) compression wedge fractures, 2% (n=2, P<0.05) lytic lesions. 15 patients in this study obtained negative bone surveys and over 60% (P<0.05) of these patients were positive for skeletal events by either Computed Tomography or Magnetic resonance imaging.
Conclusion: Skeletal related events are common in multiple myeloma. The adherence to the 2014 International myeloma working group guidelines for the diagnosis of Skeletal Related Events are poor and further training of clinicians on these guidelines are warranted.