Clinico-Pathological Profile of Multiple Myeloma: A Single-Center Study from Nepal

Multiple myeloma (MM) is a malignant plasma cell disorder characterized by monoclonal protein production and multisystem involvement, including bone destruction, anemia, renal impairment, and hypercalcemia. Despite advances in therapy, relapse is common. Disease characteristics varies from monoclonal gammopathy of undetermined significance to smoldering form, active multiple myeloma to aggressive plasma cell leukemia. Retrospective observational study of patients diagnosed with MM between January 2023 and February 2025 at a tertiary care center was done. Clinical features, laboratory parameters, radiological findings, immunofixation profiles, and treatment modalities were analyzed. Out of 21 patients were diagnosed as plasma cell neoplasm. Three had solitary plasmacytoma of bone and were excluded. Among the remaining eighteen patients, males predominated (66.6%). Mean age of presentation was 56.2 years (range 36-72 years). Median age was 56 years. Bone pain was the most common symptom (90%), followed by fatigue (39%), neurological symptoms (22%), and renal failure (5.5%). Laboratory evaluation revealed anemia in 61%, elevated beta-2 microglobulin in 78%, lytic bone lesions in 78%, and M-protein in 61%. IgG kappa was the predominant subtype (55.5%). VRD was the most commonly used treatment modality (67%). Multiple myeloma in Nepal shows heterogeneous clinical and pathological features with prominent multisystem involvement. Bone pain, anemia, and lytic lesions are common. Limited access to advanced therapies may influence outcomes. Improvements in diagnostics and treatment accessibility are required.