January 17, 2017

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