Plasma Cell Dyscrasias

Multiple myeloma, one of the common plasma cell dyscrasia, tend to present often with organ dysfunction and poor performance status in India. Proteasome inhibitors and immuno-modulatory drugs have resulted in improved outcomes in myeloma patients globally and same drugs often in generic formulations have helped patients in India and other LMICs. Despite these advances, the outcomes remain poor in Indian myeloma patients and optimal use of available resources is needed. Low-cost interventions like use of generics, maintenance, cytotoxic drugs and autologous stem cell transplant need to be integrated in management for optimal outcomes making it feasible in resource constrained settings. Here we review the presentation in Indian patients and currently practiced management algorithm at our institute.