Frequency and Prognostic Significance of Hypercalcemia in Patients with Multiple Myeloma


Background: Multiple myeloma (MM) is defined as a clonal B‑cell malignancy of the bone marrow. Hypercalcemia is associated withcancers in general and in MM specifically becomes more obvious with frequent adverse outcomes. Objectives: The objective is to determinethe frequency of hypercalcemia in MM patients and survival rate after 3 years of diagnosis with the assessment of relationship between MMprognosis and hypercalcemia. Materials and Methods: Retrospective data were reviewed from the Hematology and Cancer Centers of KurdistanRegion of Iraq (KRI, Erbil, Sulaymaniyah, and Duhok) from January 2012 to December 2017 on a sample of 130 patients with MM. Thediagnosis of MM and hypercalcemia was done according to the International Myeloma Working Group definition of MM and serum calciumof ≥11 mg/dl. Results: The prevalence of hypercalcemia among MM patients after calcium correction was 17.7%. Serum creatinine level issignificantly higher among MM patients with hypercalcemia. There was a significant association between high death rates and MM patientswith hypercalcemia. The mean survival of MM patients was 4.5 years and 72% of the MM patients had 3‑year survival, which decreasedto <41% for 6‑year survival. The survival of MM patients with hypercalcemia was significantly shorter than survival of patients withouthypercalcemia. Conclusions: The frequency of hypercalcemia among MM patients in KRI is within the international acceptable range and isregarded as a poor prognostic factor that is associated with higher mortality and shorter survival.