Case Scenario 1:
- 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.
- 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.