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.