Prevalence and Consequences of a Delayed Diagnosis in Multiple Myeloma: A Single Institution Experience

Paola Negrete-Rodríguez; Moisés Manuel Gallardo-Pérez; Olivia Lira-Lara; Miranda Melgar-de-la-Paz; Luis Enrique Hamilton-Avilés; Guillermo Ocaña-Ramm; Max Robles-Nasta; Daniela Sánchez-Bonilla; Juan Carlos Olivares-Gazca; María-Victoria Mateos; Guillermo J Ruiz-Delgado; Guillermo J Ruiz-Argüelles

doi:10.1016/j.clml.2024.03.004

Prevalence and Consequences of a Delayed Diagnosis in Multiple Myeloma: A Single Institution Experience

Clin Lymphoma Myeloma Leuk. 2024 Mar 11:S2152-2650(24)00111-3. doi: 10.1016/j.clml.2024.03.004. Online ahead of print.

Affiliations

¹ Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, México; Facultad de Medicina, Universidad de las Américas Puebla, Puebla, México.
² Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, México; Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Puebla, México.
³ Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, México; Facultad de Medicina, Universidad Veracruzana, Veracruz, México.
⁴ Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, México; Facultad de Medicina, Universidad Anáhuac Puebla, Puebla, México.
⁵ Department of Hematology, University Hospital of Salamanca (CAUSA/IBSAL) and Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain.
⁶ Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, México; Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Puebla, México. Electronic address: gruiz1@clinicaruiz.com.

PMID: 38555259
DOI: 10.1016/j.clml.2024.03.004

Abstract

Background: Multiple myeloma (MM) is a disease with unspecific initial symptoms which may lead into a delay in the diagnosis, seemingly increasing the risk of complications and in turn reducing the overall survival (OS).

Objective: To analyze the consequences of a delayed diagnosis of MM in both the OS and the progression-free survival (PFS) of the patients in a single center in México.

Methods: The study included patients with MM who were diagnosed at Clínica Ruiz, Puebla, México, between 1983 and 2022. According to the time elapsed between the onset of symptoms to the establishment of the definite diagnosis of MM, 4 groups were constructed: 1) Less than 3 months, 2) 3-6 months, 3) 6-12 months, and 4) More than 12 months.

Results: About 136 patients had a complete clinical record and at least a 3-month follow up period. A delay in the diagnosis of MM (more than 3 months from the onset of symptoms) was recorded in 92/136 persons (68%). The median follow-up for the whole group was 24.7 months, median OS was 131.4 months, whereas median PFS was 85.4 months. There was a significant trend for being in earlier stages of the disease and being diagnosed within 3 months from the onset of symptoms (P = .049). Both OS and PFS were similar in the patients diagnosed before or after 3 months from the symptoms onset (P = .772). The 6-12 months group was the group with the better median both OS (197.4 months) and DFS (197.4) from the diagnosis. The median OS for the other groups were similar among them.

Conclusion: A delay in the diagnosis of MM is very frequent in México (68% of cases); despite the fact that there was a significant trend for being in earlier stages of the disease and being diagnosed within 3 months from the onset of symptoms, we did not find a relationship between a delay on the diagnosis of the disease and a higher risk of complications and/or poor prognosis. Possible explanations to these findings are discussed.

Keywords: Overall survival; Prognosis; Progression free survival; Time to diagnosis.