Muhammad Saleem, Tahir Jameel, Masood Anwar, Parveez Ahmad, Parveen Ara Ahmad, Syed Iftikhar Ahmad Abdi.
Immunological patterns of multiple myeloma in Pakistan.
Pak J Pathol Jan ;7(4):33-8.

Multiple myeloma results from malignant proliferation of terminally differentiated Blymphocytes resulting in accumulation of plasma cells and their secretary products in blood and tissues. The class of secretary product, paraprotein, depends upon the programmed clone involved. Various paraproteins observed are IgG, IgA, IgM, IgD, IgE and their light chains either x or E. The clinical manifestations depend upon the molecular weight and specific characteristics of various paraproteins and hence vary according to the type of paraprotein. In a prospective study we determined the immunotype of myeloma in 29 consecutive patients. The commonest type was IgG myeloma constituting 55% of patients. This was followed by IgA myeloma which accounted for 27.6% of patients. Two cases each of IgM and IgD myeloma and one of IgE myeloma were seen. Bence Jones proteinuria was observed in 79.3% of patients. By and large the disease in IgA myeloma, as judged by clinical, haematological and biochemical parameters, was more aggressive as compared to other immunotypes. Multiple myeloma in Pakistan tends to occur at younger age (17!29 patients in 5th and 6th decade) and appears to be predominantly the disease of males (24 males versus 5 females). These trends could possibly be explained on the basis of differences in life expectancy, life style and exposure to environmental and occupational hazards

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