RT Journal Article
SR Electronic
T1 Presenting Signs of Multiple Myeloma and the Effect of Diagnostic Delay on the Prognosis
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 702
OP 709
DO 10.3122/jabfm.2016.06.150393
VO 29
IS 6
A1 Neta Goldschmidt
A1 Leora Zamir
A1 Alina Poperno
A1 Nathan R. Kahan
A1 Ora Paltiel
YR 2016
UL http://www.jabfm.org/content/29/6/702.abstract
AB Background: Presenting symptoms of multiple myeloma (MM) are vague and nonspecific. Early detection poses a diagnostic challenge in primary care. We assessed whether clinical and laboratory data could provide early clues to MM diagnosis and whether time to detection affects survival.Methods: A retrospective population-based study, including 110 men and women diagnosed with MM between 2002 and 2011, and matched cancer-free controls presenting with back pain. Clinical and laboratory data were extracted from medical records for the 2-year period prior to diagnosis of MM/back pain complaint.Results: During the two years prior to diagnosis 64 (58%) of MM patients complained of back pain, and 37 (34%) suffered from fatigue or weight loss. Case-control comparisons did not reveal any significant differences in the number of pain complaints or infections in the two-year prediagnostic period. However, fatigue or weight loss, anemia, elevated ESR and creatinine (p < 0.001 for all) occurred more frequently in MM patients than controls and were confirmed as independent predictors in multivariated analysis. TTD did not impact stage at diagnosis, survival, or mortality.Conclusions: Back pain accompanied by fatigue, weight loss or abnormal lab results should raise a “red flag” warning of MM. Nonetheless, we did not find evidence that TTD influences the initial stage or the prognosis of MM.