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