Monoclonal Antibodies in Relapsed Multiple Myeloma with Cristina Gasparetto, MD: Case 1

January 17, 2017

Monoclonal Antibodies in Relapsed Multiple Myeloma with Cristina Gasparetto, MD

Case Scenario 1:

January 2015

The patient is a 61-year-old male who was diagnosed with ISS stage II MM.
Performance status 0.
He was treated with lenalidomide, bortezomib, and dexamethasone (RVD) induction.
He achieved a partial response with RVD.
He then had an autologous stem cell transplantation and achieved MRD negativity.
He was started on lenalidomide maintenance of 15 mg.

April 2016

Patient was experiencing back pain, loss of appetite and weight loss.
Upon relapse cytogenetics showed a 17p deletion detected by FISH, demonstrating progression of his disease.
Beta-2 microglobulin=4.0 mg/dL, Hg=9 g/dL, creatinine=1.2 mg/dL, multiple bone lesions, bone marrow biopsy=70% plasma cells.
Performance status 1.
Based on these criteria he was diagnosed with standard-risk multiple myeloma.
He was started on daratumumab, bortezomib, and dexamethasone.