MM-588: Prevalence of plasma cell dyscrasia at the All India Institute of Medical Sciences, New Delhi, India

Abstract

Context: Plasma cell dyscrasias (PCDs) represent a diverse set of disorders defined by the malignant proliferation of monoclonal plasma cells in the bone marrow, which produce monoclonal immunoglobulins commonly known as M protein. Objective: To assess the frequency and distribution of different PCDs diagnosed at the largest tertiary care centre in India. Design, Setting, and Participants This study involved a retrospective analysis of all newly diagnosed patients with PCDs who underwent a complete baseline workup at the All India Institute of Medical Sciences, New Delhi, India, from June 2023 to February 2025. Results: A total of 140 patients were diagnosed with PCD at our center during this period, with a median age of 59 years and a male-to-female ratio of 2:1. Multiple myeloma (MM) represents the predominant type, accounting for 70% of all cases (IgG Kappa: 61%; ISS stage 3: 40.1%; high-risk patients: 21.6%; extramedullary disease [EMD]: 19.2%; light chain myeloma: 18.1%). In our cohort, additional PCDs identified included AL amyloidosis: 9.3%; solitary plasmacytoma: 6.42%; POEMS syndrome: 5.71%; Waldenstrom macroglobulinemia: 2.8%; monoclonal gammopathy of undetermined significance (MGUS): 2.14%; smouldering myeloma: 1.42%; plasma cell leukaemia: 1.42%; others: 0.71%. Conclusions: Multiple myeloma is the most prevalent plasma cell disorder, followed by AL amyloidosis and solitary plasmacytoma. The prevalence of EMD is elevated relative to published literature, potentially attributable to disease biology or the frequent utilization of PET-CT scans during initial staging assessments. The prevalence of MGUS in our population is lower than in Western countries, underscoring the necessity for a screening method that promotes early detection, suitable risk classification, and timely treatment for high-risk MGUS cases to avert progression to multiple myeloma.