Experience of the hematology laboratory at avicenne hospital in Marrakech in the diagnosis and management of multiple Myeloma

Background: Multiple myeloma is a malignant hematologic disorder marked by clonal proliferation of plasma cells in the bone marrow, leading to overproduction of monoclonal immunoglobulins. This disease is frequently associated with serious complications, including osteolytic bone lesions, hypercalcemia, anemia, and renal failure. Methods: This retrospective study reviews the clinical and biological profiles of patients with multiple myeloma diagnosed at the Hematology Laboratory of Avicenna Hospital in Marrakech. Molecular and cytogenetic biomarkers were integrated into the diagnostic strategy using advanced techniques such as next-generation sequencing (NGS) and mass spectrometry. Results: Among 120 patients studied, recurrent mutations in KRAS, NRAS, and TP53 were identified. These genetic abnormalities had a significant impact on treatment response and prognosis. Patients with TP53 mutations had poorer outcomes, while those with KRAS/NRAS mutations showed better progression-free survival (PFS). Autologous stem cell transplantation and the use of novel agents, including proteasome inhibitors and BCMA-targeted therapies, improved survival outcomes. Conclusions: The integration of molecular and cytogenetic profiling into routine diagnostic practice enhances the stratification and individualized treatment of multiple myeloma. The study underscores the clinical benefits of targeted therapies while highlighting the ongoing challenges of therapeutic resistance and access disparities.