Systematic Review on Multiple Myeloma: Its Current Prevalence, Etiology, Pathophysiology, Clinical Features, Diagnostic Criteria, Staging Challenges, Management Strategies, Complications, and Prognostic Outcomes
Jacques Forwah Ndeh *
Department of Haematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Edung Emen Samuel
Emergency Department, Basildon and Thurrock University Hospitals NHS Foundation Trust, United Kingdom.
Ofonime Benjamin Essien
Department of Haematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Bassey Okon Bassey
Department of Haematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Moday Agaei Onovoh
Department of Accident and Emergency, Medecho Locum Agency, Bushey, United Kingdom.
Oke Opeoluwa Oluwaseun
Department of General Outpatient, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.
Rukayat Olawumi Olabiyi
Department of Internal Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
Diderot Tiemen Charles
Department of Orthopaedics and Traumatology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Joy Samuel-Nwadike
Wessex Cancer Alliance NHS, Oakley Road, Southampton SO16 4GX, United Kingdom.
Ewa Anthony Obi
Department of Family Medicine, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Idiege Idiege Omang
Department of Surgery, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Adebayo Adeoye
Department of Public Health, Sheffield Hallam University, Sheffield, United Kingdom.
Chinedum Sam Iheukwumere
Department of Internal Medicine, Scarborough Teaching Hospitals NHS Foundation Trust, Scarborough, United Kingdom.
Ayobami Olukayode Alalade
Department of Emergency and Acute Medicine, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
Olasunbo Oluwaseun Oyedepo
Department of Internal Medicine, Federal Medical Centre, Owo, Nigeria.
Gbeminiyi Ebenezer Adekanmbi
Department of Internal Medicine, Southern Regional Health Authority, Clarendon, Jamaica.
Eguakun Eseosa Collins
Department of Surgery, James Cook University Hospital, United Kingdom.
Adenowo Adegbenga Adeseye
Department of General Medicine, Rolayo Medical, Lagos, Nigeria.
Aleka Joy Omari
Department of General Medicine and Surgery, Spire St Anthony's Hospital, London, United Kingdom.
Olaleke Ajayi
Department of Internal Medicine, Kulhudhuffushi Regional Hospital, Maldives.
Isu-Egwu Stella Nnenna
Department of Internal Medicine, Federal Capital Territory Administration (FCTA), Abuja, Nigeria.
Funsho Jacob Akande
Department of ENT, Federal Medical Centre, Bida, Niger State, Nigeria.
Ilevbare Martina Olohirere
Department of General Surgery, Medimax Hospital, Abuja, Nigeria.
Zahra Aliyu
Department of Accident and Emergency, National Ear Care Centre, Kaduna, Kaduna State, Nigeria.
Akaba Kingsley Onoridea
Department of Haematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar, Cross River State, Nigeria.
Nnaji Chimuanya Joseph
Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Immaculate Ihuoma Ekeagba
WORCACCCE Union Group Integrated Healthcare Sciences, Technological Development and Training and Innovative Research Foundation (WUGIHSTTAIRF), P.O Box 45, Bamenda, North West Region, Cameroon.
Ushie Godwin Abua
Department of Haematology and Blood Transfusion Sciences, Faculty of Clinical Sciences, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Abeshi Sylvester Etenikang
Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Multiple myeloma (MM) is a complex and multifaceted hematological malignancy characterized by clonal proliferation of plasma cells in the bone marrow. This process may lead to bone destruction, anemia, hypercalcemia, renal impairment, variable relapsing and refractory patterns, and poor prognostic outcomes.
Objective: This comprehensive review aims to summarize the current understanding of multiple myeloma, including its epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis.
Methodology: A systematic search of peer-reviewed literature was conducted using multiple searches across ten search engines and databases, including PubMed, Scopus, and Web of Science. The search focused on recent studies on multiple myeloma published between 2020 and 2026. Relevant articles were selected and analyzed to provide an up-to-date summary of the disease. Of 488 articles screened, 330 were included in this review.
Results: MM accounts for approximately 1.8% of all new cancer cases and 10% of hematological cancers. Incidence increases with age, with a median age at diagnosis of 70 years. Pathogenesis involves genetic mutations, epigenetic alterations, and interactions with the bone marrow microenvironment. Common clinical presentations include bone pain, anemia, hypercalcemia, and renal impairment. Diagnosis relies on serum protein electrophoresis, bone marrow biopsy, and imaging studies. Treatment options include chemotherapy, proteasome inhibitors, monoclonal antibodies, and stem cell transplantation.
Main Findings: Despite advances in treatment, multiple myeloma remains challenging in its curability with a median overall survival of 5-7 years. However, recent therapeutic innovations have improved outcomes, and ongoing research aims to identify novel targets and strategies to overcome treatment resistance and relapses.
Conclusion: MM remains clinically complex despite therapeutic advances. Continued attention to diagnostic standardization, risk stratification, treatment sequencing, supportive care, and sex-stratified outcome reporting is required to improve evidence quality and patient-centered management.
Keywords: Multiple myeloma, plasma cell dyscrasia, bone marrow malignancy, epidemiology, pathophysiology, diagnostic criteria, staging, targeted therapy, immunotherapy, prognosis