OBJECTIVE: To determine the clinical and laboratory features of newly diagnosed multiple myeloma. PATIENTS AND METHODS: Records of all patients in whom multiple myeloma was initially diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1985, to December 31, 1998, were reviewed. RESULTS: Of the 1027 study patients, 2\% were younger than 40 years, and 38\% were 70 years or older. The median age was 66 years. Anemia was present initially in 73\% of patients, hypercalcemia (calcium level \textgreater or = 11 mg/dL) in 13\%, and a serum creatinine level of 2 mg/dL or more in 19\%. The beta2-microglobulin level was increased in 75\%. Serum protein electrophoresis revealed a localized band in 82\% of patients, and immunoelectrophoresis or immunofixation showed a monoclonal protein in 93\%. A monoclonal light chain was found in the urine in 78\%. Nonsecretory myeloma was recognized in 3\% of patients, whereas light-chain myeloma was present in 20\%. Conventional radiographs showed an abnormality in 79\%. The plasma cell labeling index was 1\% or more in 34\% of patients. Multivariate analysis revealed that age, plasma cell labeling index, low platelet count, serum albumin value, and the log of the creatinine value were the most important prognostic factors. CONCLUSION: The median duration of survival was 33 months and did not improve from 1985 through 1998.

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