Correlation of Prognosis and Renal Dysfunction With Clinical and Lab Profile in Plasma Cell Neoplasms

Abstract

BACKGROUND Plasma cell neoplasms are characterised by clonal proliferation and accumulation of immunoglobulin producing B cells that typically secrete a monoclonal immunoglobulin called M-protein. 1 Multiple myeloma is the commonest of the plasma cell neoplasms with an annual incidence of 1% of all malignancies and 10% of all haematological malignancies. 2 Indian incidence is approximately 6,000 new cases/year. 3 Renal complications develop in 20%-25% of myeloma. 4 Various new methods like cytogenetics and serum β2 microglobulin estimation are ideal in measuring the prognosis of myeloma. 5 But, these are not available in most institutes. So, this study is done to assess the association of prognosis and renal dysfunction in plasma cell neoplasms based on routine clinical, hematological and biochemical variables. MATERIALS AND METHODS Patients were followed up for a maximum period of 3 years to evaluate the prognosis. Renal dysfunction was measured using serum creatinine and blood urea estimation. Statistical Analysis-The data was analysed with the help of computer software SPSS version 18. RESULTS Fifty seven patients were newly diagnosed with plasma cell neoplasms. Male gender, thrombocytopenia, presence of recurrent infections and hyperphosphatemia were associated with bad prognosis. 28% of the study population had renal involvement at presentation. The factors which showed statistically significant association with renal dysfunction were serum calcium and serum phosphate. CONCLUSION Reasonably good assessment of prognosis and risk of renal failure can be made by evaluating routine parameters like gender, platelet count, serum phosphate, serum calcium and the presence of recurrent infections.