ONCAlert | 2018 SGO Annual Meeting on Women’s Cancer
Multiple Myeloma Case Studies

Case Studies: Monoclonal Antibodies in Relapsed Multiple Myeloma with Ola Landgren, MD, PhD

Ola Landgren, MD, PhD, reviews the goals of therapy and treatment options with monoclonal antibodies in relapsed multiple myeloma using case-based scenarios.

Monoclonal Antibodies in Relapsed Multiple Myeloma with Ola Landgren, MD, PhD: Case 1

Case Scenario 1:

January 2015

  • The patient is a 61-year-old male who was diagnosed with ISS stage II MM.
  • Performance status 0.
  • At diagnosis bone marrow shows 40% light chain restricted plasma cells, FISH cytogenetics show hyperdiploid phenotype.
  • M-spike of 3.2 g/dL IgG kappa, serum free light chains kappa 60 mg/dL, lambda 1.5 mg/dL, ratio=40
  • Bloodwork show beta-2 microglobulin=4.2 mg/dL, Hg=8.2 g/dL, creatinine=0.9 mg/dL.
  • PET/CT shows multiple focal bone lesions in upper and lower extremities and in L2 and L3.Bone lesions have increased SUVs.
  • Based on these data and diagnosis of standard risk he was started on lenalidomide, bortezomib, and dexamethasone (RVD) induction.
  • He achieved a partial response with RVD.
  • He then had an autologous stem cell transplantation and achieved MRD negativity.
  • He was started on lenalidomide maintenance of 10 mg.

April 2016

  • Patient was experiencing back pain, loss of appetite and weight loss.
  • Blood work show beta-2 microglobulin=4.0 mg/dL, Hg=9 g/dL, creatinine=1.5 mg/dL.
  • M-spike is 0.5 g/dL, serum free light chains kappa 60 mg/dL, lambda 0.6 mg/dL, ratio=10.
  • Performance status 1.
  • Based on these criteria he was diagnosed with standard-risk multiple myeloma.
  • He was started on daratumumab, bortezomib, and dexamethasone.
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