Outcomes in Newly Diagnosed Transplant-Ineligible Multiple Myeloma

Case: 83-Year-Old Man With NDMM Ineligible for Transplant

History and Presentation:

• 83-year-old man c/o back pain and fatigue
• Cardiac stent placed 3 years ago; high blood pressure; BMI 32

Diagnostic Workup:

• Laboratory findings
  • M-protein 3.8 g/dL
  • Hb 7.9 g/dL
  • LDH 290 IU/L
  • Albumin 3.9 g/dL
  • β2-microglobulin 4.25 mg/L
  • Creatinine 1.5 mg/dL
  • FLC kappa 134 mg/dL

• Bone marrow biopsy
  • Good cellularity with 60% bone marrow plasma cells
• Cytogenetics/FISH: standard-risk, no cytogenetic abnormalities
• Imaging
  • MRI of the spine: multiple focal lesions; moderate diffuse infiltration of spine, pelvis, and proximal femurs.
• ECOG PS: 2
• Durie-Salmon PLUS Stage IIIA IgG multiple myeloma requiring treatment with symptomatic anemia and bone lesions

Treatment:

Patient was started on D-Rd