Multiple myeloma (MM) symptoms are generally nonspecific, according to a study published online June 25 in Cancers.
Stella Bowcock, M.D., from the King’s College Hospital NHS Trust in the United Kingdom, and colleagues explored the presenting symptoms to identify early signs of MM and their association with organ damage. Symptoms were recorded in the patients’ own words at diagnosis. Patients who were seen by a hematologist more than six months before MM diagnoses were categorized as having precursor disease (PD). Data were provided by 962 of 977 patients.
The researchers found that the predominant symptoms were back pain, other pain, and systemic symptoms (38, 31, and 28 percent, respectively). Bone pain was rarely a complaint, but pain was. Vertebral fractures were underrecognized as pathological and were the predominant cause of irreversible organ damage (27 percent of patients), affecting performance status (PS) and associated with back pain, bone disease, and age older than 65 years (odds ratios, 6.14, 3.71, and 1.58, respectively). Renal failure occurred less often and was associated with gastrointestinal symptoms, age older than 65 years, and absence of back pain (odds ratios, 2.23, 2.14, and 0.44, respectively). Fewer vertebral fractures, fewer adverse features, less decline in PS, and a lower stage were seen for the 149 patients with known PD versus the 813 with de novo MM.
“Myeloma symptoms are nonspecific, and therefore, a long diagnostic pathway is likely to continue if we rely upon health care workers to think of the diagnosis before a myeloma screen is performed,” the authors write.