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Multiple Myeloma Case Studies

Case Studies: Asymptomatic Relapsed Multiple Myeloma

Ajai Chari, MD, PhD, provides insight on treating patients with standard-risk, asymptomatic, relapsed multiple myeloma.

Asymptomatic Relapsed Multiple Myeloma

Case:  56-Year-Old Man With Asymptomatic Relapsed Multiple Myeloma

History:

  • In 2015, at the age of 53, an African-American man was diagnosed with multiple myeloma; R-ISS stage I
  • Patient was treated with bortezomib + lenalidomide + dexamethasone (VRd) for 4 cycles, followed by ASCT
  • Patient achieved a VGPR
  • Received lenalidomide maintenance for 2 years

September 2018

  • On routine follow-up, no clinical symptoms observed
  • Imaging: stable disease
  • Laboratory results:
    • Hb, 11.3 g/dL
    • Ca2+ 9.2 mg/dL
    • Creatinine, 0.8 mg/dL
    • M-protein:
      • June: 1.2 g/dL
      • July: 1.4 g/dL
      • August: 1.7 g/dL
  • Cytogenetics/FISH: no adverse cytogenetics
  • ECOG PS: 0
  • Patient was started on ixazomib + lenalidomide + dexamethasone (IRd)
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