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BACKGROUND: Health-related quality of life (HRQoL) in multiple myeloma (MM) gained increasing importance to ensure that the improved survival is associated with improved life quality. OBJECTIVES: The aim of this study was to assess the HRQoL in a cohort of myeloma patients from Kurdistan region in Iraq. MATERIALS AND METHODS: This observational, cross-sectional, multi-center study enrolled 138 patients with symptomatic MM patients. The patients' records were retrieved and they were also clinically assessed and appropriately investigated at the time of enrolment. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Multiple Myeloma module (EROTC QLQ-MY20. RESULTS: The 138 patients included had a mean age of 60.4 years and included 83 males and 55 females. Significant predictors of worse HRQoL disease symptoms and side effects of treatment domains included increasing age, female sex, and increase number of treatment courses. Other predictors associated with worse disease symptom domain include presence of bone lesions and nonsecretory myeloma versus light chain myeloma. Basic parameters including the concentration of monoclonal band, hemoglobin, serum creatinine, calcium, and albumin were not significant associated with scores in any of the domain while serum LDH was associated with worse side effects of treatment scores. Furthermore, it was noted that patients who had underwent autologous stem cell transplants had better HRQoL in all domains compared to other modalities of therapy, though this did not reach significance. CONCLUSIONS: HRQoL in MM treated in Iraqi Kurdistan is not much different from their Western counterparts and several predictors of worse QoL were identified in this cohort of patients.

Background: Multiple myeloma (MM) is defined as a clonal B-cell malignancy of the bone marrow. Hypercalcemia is associated with cancers in general and in MM specifically becomes more obvious with frequent adverse outcomes. Objectives: The objective is to determine the frequency of hypercalcemia in MM patients and survival rate after 3 years of diagnosis with the assessment of relationship between MM prognosis and hypercalcemia. Materials and Methods: Retrospective data were reviewed from the Hematology and Cancer Centers of Kurdistan Region of Iraq (KRI, Erbil, Sulaymaniyah, and Duhok) from January 2012 to December 2017 on a sample of 130 patients with MM. The diagnosis of MM and hypercalcemia was done according to the International Myeloma Working Group definition of MM and serum calcium of ≥11 mg/dl. Results: The prevalence of hypercalcemia among MM patients after calcium correction was 17.7%. Serum creatinine level is significantly higher among MM patients with hypercalcemia. There was a significant association between high death rates and MM patients with hypercalcemia. The mean survival of MM patients was 4.5 years and 72% of the MM patients had 3-year survival, which decreased to

Background: Nowadays, the therapy of multiple myeloma (MM) has successful and hopeful outcomes. Worldwide, various treatment regimens are prescribed by clinical hematologists. Objectives: The objective was to evaluate response to induction treatment and survival of MM patients treated with various treatment regimens in the Kurdistan Region of Iraq (KRI). Materials and Methods: A total of 114 patients in the KRI were included in a retrospective study through the period of January 1, 2010, to September 31, 2019. The diagnosis of MM was confirmed using the International Myeloma Working Group (IMWG) guidelines. The treatment responses were assessed according to the IMWG response criteria. Results: Complete response among the MM patients was 35.7%, very good partial response (VGPR) was 28.7%, partial response reached 9.1%, and stable disease reached 16.5%. The Kaplan–Meier curve showed those with VGPR had better survival than the rest of the response categories. Meanwhile, there was a significant association between MM patients on bortezomib and dexamethasone treatment regimen and complete remission was noticed (P = 0.02). Conclusions: The combination therapy of bortezomib and dexamethasone is effective in achieving a better response to treatment and good survival than other therapy regimens.

Multiple myeloma (MM) is a malignancy of the plasma cells. The study aimed to know the clinical diversity of MM at presentation, the time lapse from the first symptoms to diagnosis, and the association of this time lapse with the International Staging System (ISS) of MM. This is a retrospective observational study that was performed on 176 patients who had MM and were admitted to Hiwa Hospital in Sulaimani, Nanakaly Hospital in Hawler, and Azadi Hematology - Oncology Center in Duhok, from October 2010 to December 2019. Demographic and detailed clinical features were recorded, and the ISS of MM was used to assess possible effects of time lapse on patients’ outcomes. The mean ± SD (standard deviation) of patients’ age was 60.58 ± 11.54 years, and the majority of the patients (52.27%) were from Sulaimani. Most of them had an O+ blood group and a body mass index (BMI) of more than normal (30.68%, and 63.63%, respectively). Most of the patients had bone pain, ≥2 lytic lesions, hypocalcemia and hypercalcemia, and renal impairment and stage II and III of ISS of MM at the time of diagnosis (78.98%, 32.39%, 49.43%, 89.77%, and 75.1%, respectively). Furthermore, their mean ± SD of time lapse from the first symptom to diagnosis was 3.01 ± 3.18 months, and its association with ISS was none significant. The clinical features of MM at diagnosis are mostly nonspecific, and may be shared by a wide range of clinical conditions. However, patients who have fatigue, bone pain, renal impairment, pallor, and infective events should arouse the clinical suspicion of MM.