Frequency and prognostic significance of hypercalcemia in patients with multiple myeloma

Kanar J Karim; Abid M Hassan; Hisham A Getta; Najmaddin S. H. Khoshnaw; Sana D Jalal; Akram M Mohammed; Kawa M Hasan; Dana A Abdullah; Ameer I A. Badi; Ahmed K Yassin; Banaz M Safar; Basil K Abdulla; Rawand P Shamoon; Truska A Amin; Zeki A Mohamed; Ali I Mohammed; Diveen J Hussein; Nawsherwan S Mohammed; Rezhin N Rajab; Firiad Hiwaizi

doi:10.4103/MJBL.MJBL_54_20

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ORIGINAL ARTICLE

Year : 2020 \| Volume : 17 \| Issue : 4 \| Page : 327-331

Frequency and prognostic significance of hypercalcemia in patients with multiple myeloma Kanar J Karim¹, Abid M Hassan², Hisham A Getta³, Najmaddin S. H. Khoshnaw¹, Sana D Jalal³, Akram M Mohammed¹, Kawa M Hasan⁴, Dana A Abdullah³, Ameer I A. Badi⁵, Ahmed K Yassin⁴, Banaz M Safar¹, Basil K Abdulla¹, Rawand P Shamoon⁶, Truska A Amin¹, Zeki A Mohamed², Ali I Mohammed³, Diveen J Hussein⁷, Nawsherwan S Mohammed⁶, Rezhin N Rajab⁷, Firiad Hiwaizi⁷ ¹ Department of Hematology, Hiwa Cancer Hospital, Sulaymaniyah, Iraq ² Department of Medicine, University of Duhok, Duhok, Iraq ³ Department of Pathology, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq ⁴ Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq ⁵ Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq ⁶ Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq ⁷ Department of Hematology, Nanakali Hospital, Erbil, Kurdistan Region, Iraq Correspondence Address: Kanar J Karim Department of Hematology, Hiwa Cancer Hospital, Sulaymaniyah, Kurdistan Region Iraq Source of Support: None, Conflict of Interest: None DOI: 10.4103/MJBL.MJBL_54_20

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.



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