Demographic profile, risk stratification, clinical characteristics, and treatment outcome of patients with multiple myeloma: A five-year retrospective study at a tertiary hospital in Ethiopia

Background Patients with multiple myeloma are being seen at an increasing frequency in different indigenous African population. However, local data regarding the demographic profile, clinical characteristics, risk stratification, and treatment outcome of these patients is lacking. This study was designed to fill this existing gap in our setup. Hence, it will aid in the revision of treatment guidelines based on local data on the efficacy of existing treatment regimens and risk stratification of patients with a newly diagnosed multiple myeloma. Methods A single centered Hospital-based retrospective Cohort study was conducted from January 2015 to December 2019. Eighty patients with newly diagnosed MM who received non-proteasome inhibitor-based therapy at TASH, Addis Ababa, Ethiopia were analyzed in the study. Results Out of the 80 patients in this cohort, 51(63.8%) of the patients were males (M: F ratio 1.76:1 ) and the median age at diagnosis was 52 years. The commonest complications identified were anemia (56.3%) and pathologic fracture (55%). The commonest comorbid conditions were; systemic hypertension (24%), CKD (6.3%), and diabetes (5%). The median Progression-Free Survival (PFS) and Overall Survival (OS) of patients were found to be 17.5 and 20 months respectively. This study also identified factors like advanced DS stage, presence of plasmacytoma, renal dysfunction, elevated serum LDH, high levels of serum protein, and monoclonal M-protein to have adverse implication on the OS and PFS of patients. Conclusion Multiple Myeloma is more common in the male population group and our patients are younger than the western population. Myeloma treatment regimens like CP and CPT are found to be less effective in our patients than in patients elsewhere. This is likely to be due to the advanced stage at presentation. In resource-limited setups, where determination of cytogenetic features of myeloma is difficult, different clinical and laboratory parameters can still serve as prognostic markers of treatment outcome & patient survival. Competing Interests The authors declare that they have no competing interests ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The IRB of Addis Ababa University school of medicine department of internal medicine gave the ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * ### List of Abbreviations ASCT : Autologous Stem cell Transplant CVD : Cardiovascular disease CP : Cyclophosphamide – Prednisolone CPT : Cyclophosphamide – Prednisolone-Thalidomide D-S : Durie-Salmon IMIDs : Immunomodulatory drugs ISS : International Staging System LDH : Lactate Dehydrogenase MM : multiple myeloma MPT : Melphalan – Prednisolone – Thalidomide OS : Overall Survival PFS : Progression-free Survival TASH : Tikur Anbessa Specialized Hospital TP : Thalidomide – Prednisolone UNL : Upper normal limit VTE : Venous Thromboembolism