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