Systematic Review on Multiple Myeloma: Its Current Prevalence, Etiology, Pathophysiology, Clinical Features, Diagnostic Criteria, Staging Challenges, Management Strategies, Complications, and Prognostic Outcomes

Abstract

Background: Multiple myeloma (MM) is a complex and multifaceted hematological malignancy characterized by clonal proliferation of plasma cells in the bone marrow. This process may lead to bone destruction, anemia, hypercalcemia, renal impairment, variable relapsing and refractory patterns, and poor prognostic outcomes. Objective: This comprehensive review aims to summarize the current understanding of multiple myeloma, including its epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis. Methodology: A systematic search of peer-reviewed literature was conducted using multiple searches across ten search engines and databases, including PubMed, Scopus, and Web of Science. The search focused on recent studies on multiple myeloma published between 2020 and 2026. Relevant articles were selected and analyzed to provide an up-to-date summary of the disease. Of 488 articles screened, 330 were included in this review. Results: MM accounts for approximately 1.8% of all new cancer cases and 10% of hematological cancers. Incidence increases with age, with a median age at diagnosis of 70 years. Pathogenesis involves genetic mutations, epigenetic alterations, and interactions with the bone marrow microenvironment. Common clinical presentations include bone pain, anemia, hypercalcemia, and renal impairment. Diagnosis relies on serum protein electrophoresis, bone marrow biopsy, and imaging studies. Treatment options include chemotherapy, proteasome inhibitors, monoclonal antibodies, and stem cell transplantation. Main Findings: Despite advances in treatment, multiple myeloma remains challenging in its curability with a median overall survival of 5-7 years. However, recent therapeutic innovations have improved outcomes, and ongoing research aims to identify novel targets and strategies to overcome treatment resistance and relapses. Conclusion: MM remains clinically complex despite therapeutic advances. Continued attention to diagnostic standardization, risk stratification, treatment sequencing, supportive care, and sex-stratified outcome reporting is required to improve evidence quality and patient-centered management.