Retrospective analysis of treatment outcome and complications of young patients (less than 41 years old) with multiple myeloma among patients treated at king faisal specialist hospital & research center jeddah in the period 2011 to 2024, a single

Abstract Background: Multiple Myeloma (MM) is a Hematological malignancy of B-cell plasma cell that affects elderly population. It is the second most common malignancy after lymphoma. Little is known about the prevalence and presentation of this disease in Saudi Arabia. We are here reporting the retrospective analysis of treatment outcomes and complications among Saudi patients. Methodology: In the period of January 1st 2011 till March 31st, 2024 all patients with MM were identified through our oncology data unit (ODU) after IRB approval (IRB 2023-94). A case reporting form was used (CRF) for data collection, and there is no conflict of interest. Artificial Intelligence (AI) was not used in any part of the research or abstract submission. Results: Over a period of 15 years a total of 147 patients were identified, among these 88 were men (representing 88/147 59%) and 59 were women (representing 59/147 41%). Of these cases 92 were below the age of 61 representing 63 % of the population (92/147). Among these cases below the age of 61, 14 cases were identified below the age of 41 representing 15% (14/92) and 10% of the whole retrospective cohort (14/147). Among these young population 57% were women (8/14) and 43% were men (6/14). The survival of these patients was 57% also (8/14) whereas the mortality was only 43% (6/14). of the patients who died one third were women and the other two thirds were men (2/6 & 4/6 respectively). Upfront tandem transplant in a period of less than 6 months offered a survival advantage for those patients who are still alive especially for those who were diagnosed below the age of 30. Rapid relapse and disease progression to plasma cell leukemia was seen in patients with extra-medullary disease (EMD) relapse rather than at the time of disease presentation. The diagnostic and therapeutic interventions changed dramatically over the past 15 years and our practice is matching the international development of the management of MM. Most patients who were transplant eligible, received autologous bone marrow transplantation and tandem transplant was performed for young population. Many patients had chronic kidney disease related to excessive use of NSAIDs for pain management prior to the diagnosis as well as due to late diagnosis of MM. Conclusion: Our data confirmed that our current management of patients with MM is matching the international standards, however, aggressive protocols and tandem transplant in very young population along with double maintenance is in favor of this limited number population. Early detection of plasma cell dyscrasia will enable better prevention of late complications of MM. Future prospective studies addressing the early diagnosis and interventions are needed.