Managing High-Risk Multiple Myeloma

April 23, 2018

Managing High-Risk Multiple Myeloma

  • A 74-year-old woman presented with anemia, proteinuria, renal insufficiency, and pain in her right hip
  • History: chronic HTN, aortic insufficiency, diabetes mellitus
  • ECOG performance status, 1
  • 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, 10.1 g/dL
    • Ca2+3.32 mmol/L
    • Creatinine, 1.9 mg/dL
    • Creatinine clearance, 30 mL/min
    • M-protein, 1.4 g/dL
    • B2M, 4.9 mcg/mL
    • SFLC, kappa, 150 mg/dL
  • Bone marrow biopsy, 70% plasma cells
  • Molecular testing, del17p