Interdisciplinary approach to multiple myeloma – time to diagnosis and warning signs. Issue 4 (21st March 2021)

• Record Type: Journal Article
• Authors: Herget, Georg W.; Kälberer, Felix; Ihorst, Gabriele; Graziani, Giulia; Klein, Lukas; Rassner, Michael; Gehler, Christian; Jung, Johannes; Schmal, Hagen; Wäsch, Ralph; Engelhardt, Monika
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 4(2021)
• Page Start: 891
• Page End: 898
• Publication Date: 2021-03-21
• Subjects: Multiple myeloma; -- symptoms; -- time to diagnosis; -- oncologist; -- orthopedist; -- warning signs; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1849681
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Delayed diagnosis is a common challenge in the management of multiple myeloma (MM). This prospective interdisciplinary study evaluated symptoms and time to diagnosis (TTD) in 81/295 screened patients at our tertiary center, who were examined by an orthopedist prior to the MM diagnosis. The most frequent complaint was back pain (81%), mainly localized thoracic and/or lumbar. Pain was independent of movement in 85%, occurred at night in 69%, and at multiple localizations in 30% of patients. Notably, 63% patients with an orthopedic disease noticed substantial symptom change before the MM diagnosis was made. The median TTD was 7 months and did not differ significantly between patients with or without a preexisting skeletal disease. To avoid delayed diagnosis, physicians should consider MM as a differential diagnosis, whenever warning signs such as skeletal pain independent from movement, at night, at various localizations, and change in pain characteristics accompanied by fatigue, are reported.