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

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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.
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