Multiple myeloma in Nigeria: are we diagnosing it enough?

Multiple myeloma (MM) is a malignant plasma cell dyscrasia characterized by the expansion of monoclonal plasma cells. It is diagnosed based on certain criteria with the acronym CRAB (hyperCalcemia, Renal insufficiency, Anaemia, and lytic Bone lesion), along with increased bone marrow plasma cells. MM is one of the most common haematological malignancies in the Western world. It is also more common in African Americans than in Caucasians. However, in most of Africa, especially West Africa, and particularly Nigeria—the most populous Black nation on Earth—a very low incidence rate and prevalence have been reported. It is believed that this may not actually be representative of the factual situation and may instead be a result of a low index of suspicion and the prohibitive cost of diagnostic tests. However, more profoundly, the reason for the low index of suspicion may be the anomalous presentation of some cases of MM, which may be befuddling even to the experts; hence, diagnosis can be missed. This review intends to look at some of the recondite points, as well as other germane issues, pertaining to MM diagnosis in Nigeria. It recommends running a new and comprehensive screening research project to obtain better data on the incidence of monoclonal gammopathy in Nigeria.