Prevalence and consequences of a delayed diagnosis in multiple myeloma: A single institution experience

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, four groups were constructed: 1) Less than 3 months, 2) 3-6 months, 3) 6-12 months, and 4) More than 12 months. Results 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 three 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 three months from the onset of symptoms (p = .049). Both OS and PFS were similar in the patients diagnosed before or after three months from the symptoms onset (p = 0.772). 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 three 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. Micro abstract A delay in the diagnosis of Multiple Myeloma is very frequent in México; in this study 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.