|Videos|December 13, 2019

Transplant-Eligible Newly Diagnosed Multiple Myeloma

Transplant-Eligible Newly Diagnosed Multiple Myeloma

Case: 75-Year-Old Woman with Newly Diagnosed Multiple Myeloma

History and Presentation:

  • 75-year-old woman; diabetic on metformin, no history of coronary artery disease or other comorbidities
  • κ light chain multiple myeloma diagnosed November 2019
    • Durie-Salmon Stage IIIA, ISS Stage 2
  • Laboratory findings
    • Total proteinuria 5.82 g/day
    • Bence Jones protein (BJP) 3.6 g/day
    • Hypogammaglobulinemia
    • Albumin 3.9 g/dL
    • β2-microglobulin 4.7 mg/L
    • Creatinine 1.7 mg/dl
    • No paraprotein peak but kappa light chain 2000 with lambda light chain at 1
    • Kappa/lambda ratio=2000
  • Bone marrow biopsy
    • Cellularity 25% with 80% plasma cells
  • Cytogenetics 46, XX
  • FISH no abnormalities
  • Imaging
    • Skeletal survey: extensive lytic bone disease with healing fractures of left 7thand the 8thribs
    • MRI of the spine: multiple compression fractures
    • MRI of the pelvis: diffuse marrow infiltrative changes due to myeloma
  • Cytogenetics/FISH: no adverse cytogenetics
  • ECOG PS: 1
  • Patient was started on D-VRd

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