PRESENTING SIGNS AND SYMPTOMS IN MULTIPLE-MYELOMA - HIGH PERCENTAGES OF STAGE-III AMONG PATIENTS WITHOUT APPARENT MYELOMA-ASSOCIATED SYMPTOMS

We studied the medical histories of 127 patients diagnosed with multip le myeloma included in a population-based registry of 945 patients wit h a paraprotein or multiple myeloma in the region of the Comprehensive Cancer Center West (CCCW). We defined patients ''not immediately diag nosed'' or ''delayed diagnosis'' as those patients in whom myeloma was not included in the initial differential diagnosis. We found that 37% belonged to this category. These patients more often had symptoms not associated with multiple myeloma. Since a surprising 51% of patients with delayed diagnosis turned out to have stage-III myeloma, the physi cian should be alert to the presence of this disease, despite the fact that co-morbidity may mask its presence.