Epidemiological Landscape and Treatment Access of Multiple Myeloma in Bangladesh: A Review from LMIC

Abstract

Introduction: Multiple myeloma (MM) is a malignant clonal plasma cell disorder with a high level of morbidity in the form of anemia, kidney failure, hypercalcemia, and lytic bone disease. Despite the increasing rate of global disease burden, the evidence in the low and middle-income countries is inadequate, especially in Bangladesh.This review aims to present the epidemiological, clinical, laboratory, and disease staging of multiple myeloma patients reported in Bangladesh studies.

Methodology: The study included the published literature on MM in Bangladesh till November 2025 from observational studies, case series, retrospective analyses, and review articles. The data extraction was about demographics, clinical presentation, laboratory values, and skeletal findings. All data that was included was tabulated and analyzed with the help of MS Excel and SPSS version 20.0.

Results: In the literature review, the mean/median age was 51.9-58.9 years, and the prevalence was two-thirds male (~55% to 90%) in different publications. The most frequent presenting complaint was bone pain (up to ~70–80%), anemia (≈70–75%), fatigue, with ESR often above 100 mm/hr. Renal impairment (creatinine 2mg/dl and above) was identified in 20% to 34% of patients, hypercalcemia and Bence-Jones proteinuria in approximately 30% to 50%. The presence of lytic bone lesions had been reported in 60-80% of patients, most often of the vertebrae, ribs, and skull. IgG was the major fixation, and 2-microglobulin (>5.5 mg/L) was detected in over half of the patients, with the majority presenting at ISS stage III. Cohort bone marrow plasma cell infiltration was between 40% and 70%.

Conclusion: The literature reviewed on Bangladesh has repeatedly shown late presentation and high disease burden of MM patients. Access to limited diagnostic opportunities and late diagnosis are contributory factors to the disease at an advanced stage.