During a live event, Robert Orlowski, MD, PhD, and participants discussed how access barriers, disease tempo, and bridging choices shape CAR T referral for a patient with early relapsed multiple myeloma.
|Videos|April 7, 2021
A 75-Year-Old Man With Multiple Myeloma
Author(s)Jonathan L. Kaufman, MD
A key opinion leader in hematology, Jonathan Kaufman, MD, provides insight into the case of a 75-year-old man with multiple myeloma and discusses treatment considerations, standard of care therapies, and recent clinical trial updates for the management of multiple myeloma.
Advertisement
Case: A 75-Year-Old Man with Multiple Myeloma
Initial Presentation
- A 75-year-old man presents with worsening fatigue on exertion, pallor, and hip pain
- PMH: osteoarthritis
- PE: tired appearing male, poor hand-grip strength, mild tenderness on palpation of the left hip
- ECOG 2
Clinical workup
- Hb 9.8 g/dL, corrected calcium 11.9mg/dL, LDH 295U/L, creatinine 1.4mg/dL, albumin 3.7g/dL, CrCl 50mL/min
- Peripheral blood smear showed rouleaux formation
- Beta-2 microgloblulin 5.1 mcg/mL, M-protein 2.2 g/dL
- Lambda free light chains: 0.6 mg/dL, kappa free light chains: 14.3 mg/dL, ratio: 29 (k/l)
- FISH: hyperdiploid
- UPEP: M-spike of 400 mg of lambda light chains in 24 hours
- PET/CT revealed lytic bone lesions in the left hip
- Bone marrow biopsy shows 58% plasma cells IgG k
- Diagnosis: ISS and R-ISS, standard risk, stage II MM
Treatment
- Patient is ineligible for ASCT due to comorbidities
- Initiated treatment with daratumumab + bortezomib + melphalan + prednisone
Advertisement
Related to this article
The phase 3 VERIFY trial found that rusfertide improved clinical response, reduced phlebotomy requirements, and eased symptom burden in patients with polycythemia vera receiving standard-of-care therapy.
During a virtual event, Thomas Martin, MD, and participants considered the use of the on-body injector for subcutaneous isatuximab for a frail patient with transplant-ineligible newly diagnosed myeloma.
Multiple oncologists share their perspectives on what is still limiting access to CAR T-cell therapies in 2026.
Advertisement
Advertisement
Trending on Targeted Oncology - Immunotherapy, Biomarkers, and Cancer Pathways
1
Oncologists Debate Role of On-Body Injector for Transplant-Ineligible Myeloma
2
MC001 Receives FDA Fast Track Designation in Pancreatic Cancer
3
Insurance Delays and Travel Strain CAR T Referral in Early Relapsed Myeloma
4
FET-PET, Molecular Testing, and Personalized Treatment Push Brain Tumor Care Forward
5