Case Scenario 2: January 2015 The patient is a 72-year old female who was diagnosed with ISS stage I multiple myeloma. She is an insulin dependent diabetic who is experiencing peripheral neuropathy. Her cytogenetics were classified as standard risk, bone marrow show 50% light chain restricted plasma cells. M-spike IgG lambda 2.5 g/dL, Performance status 1. She received treatment with lenalidomide (25 mg daily) and low-dose dexamethasone and obtains a very good partial response. After a year she decided to come off of lenalidomide therapy. July 2016 Six months after stopping therapy,patient had increasing fatigue and weakness. M-spike is now 0.8 g/dL. CT scan revealed several bone lesions. Patient was started on daratumumab, lenalidomide and dexamethasone