Abstract

Background: Multiple myeloma (MM) is a malignancy of terminally differentiated clonal plasma cells. Expansion of the malignant 
plasma cells throughout the bone marrow (BM) leads to cytopenias, bone resorption and production of monoclonal immunoglobulins 
known as M components or paraproteins. BM analysis is an important element in establishing the diagnosis of MM. The study aims 
to evaluate the diagnostic yield of bone marrow aspirate and bone marrow biopsy in patients with MM. and to Compare the newly 
diagnosed and follow-up cases (regarding the bone marrow examination, hematological and biochemical parameters).
Methods: This is a cross-sectional study conducted from the first of August 2022 to the first of August 2023, and included 32 patients 
with MM. The patients were diagnosed at the Basrah Oncology and hematology center. The laboratory parameters and BM 
examination were analyzed and correlated. Immunohistochemical staining with CD138 was done for selected cases.
Results: Anemia (Hemoglobin (Hb) < 10 g/dL) was seen in 59.4% of total cases. Hypercalcemia was found in 9.4% of total cases. 
Serum creatinine of more than 2 mg/dL was found in 25% of total cases. Monoclonal (M) protein was positive in 84.4% of total 
cases. There is a significant difference between the positive results of BMA and BMB.
Conclusions: BMA and BMB complement each other for BM evaluation. The combined use of BMA smears, HE stained BMB 
sections and CD138 IHC is beneficial in obtaining the most clinically relevant BM plasma cell percentage.