B-359 The prevalence of multiple myeloma and types among age groups and gender as well as M-component correlation with biochemical parameters

Abstract

Background Multiple Myeloma (MM) is often characterized by laboratory detection of a monoclonal band on protein electrophoresis and the finding of elevated free light chains (FLC) ratio. Although several risk factors for MM have been reported, the association of monoclonal type and extent of FLC production with the patient’s gender and age are far less pronounced. This study investigated the relative distribution of monoclonal isotype and FLC ratio among patients with MM, their age, and the various MM-associated comorbidities. Methods This is a retrospective study from a large county hospital. Laboratory and clinical findings among patients presenting to a large public safety count hospital between January 2021 and December 2024 were reviewed. Protein electrophoresis and immunofixation were performed using the Seibia system, whereas FLC measurements were performed at a reference laboratory using an immunoturbidimetry-based methodology. Results A Total number of 269 patients with protein electrophoresis results were entered into the study. Among the study patients, 71(26.4%), 57(21.2%), 24(8.9%), 60(22.3%), and 92 (34.2%) had a clinical presentation of bone disorder, chronic kidney disease, anemia, neuropathy, and hematological bone malignancy respectively. 91(34%) patients expressed monoclonal bands on electrophoresis. There were no gender differences (male= 45 (16.7%) and female 46 (17.1%)). The prevalence of MM among the 30-39, 40-49, 50-59, 60-69, and >70 years age groups had 1%, 9.9%, 16.5%, 45%, and 27.5% respectively. The monoclonal bands frequence among study patients were typed as IgG-kappa in 50 (54.9%), IgG-lambda in 21(23.1%), IgA-kappa in 6(6.6%), IgA-lambda in 9(9.9), IgM-kappa in 3(3.3%) and IgM-lambda in 2(2.2%) patients. Patients with MM had a significantly higher level of total protein (p-value 0.04), globulin (p-value 0.029), and FLC-ratio (p-value 0.022) compared to patients without an M-component. The level of the respective M-component positively correlated with FLC-kappa (p-value<0.0001) and FLC-ratio (kappa/lambda) (p-value<0.0001) whereas the level significantly but negatively correlated with hemoglobin levels (P< 0.006). However, we did not observe a significant correlation between the respective M-component and FLC-lambda (P 0.6319). Conclusion Although there was no apparent gender association, this study showed that the prevalence of multiple myeloma increases with age and that IgG-kappa is the predominant type followed by IgG-lambda.