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Multiple Myeloma Case Studies

Case Studies: Treating High-Risk Multiple Myeloma

In this case-based interview, Ajai Chari, MD, discusses the case of a 74-year-old woman with high-risk transplant-ineligible multiple myeloma and the treatment options available.

Treating High-Risk Multiple Myeloma

  • A 74-year-old woman was admitted to the ICU with pneumococcal bacteremia. She complained of recent severe fatigue, loss of appetite, nausea
  • History: chronic HTN, aortic insufficiency, diabetes mellitus
  • X-ray of the pelvis showed numerous lytic lesions in the ilium and a large lesion in the right proximal femur
  • MRI confirmed a 9-mm lesion in the right femoral head and numerous bilateral T1 hypointense and T2 hyperintense lesions in both iliac region
  • Laboratory results:
    • Hb, 8.3 g/dL
    • Ca2+ 16.35 mg/dL
    • Creatinine, 1.0 mg/dL
    • Creatinine clearance, 59 mL/min
    • M-protein, 1.6 g/dL
    • B2M, 4.9 mcg/mL
    • SFLC, kappa, 150 mg/L
  • Bone marrow biopsy, 70% plasma cells
  • Molecular testing, t(4;14)
  • ECOG 2
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