Treatment of Multiple Myeloma with High-Risk Cytogenetics
September 10, 2018
Treatment of Multiple Myeloma with High-Risk Cytogenetics
A 55-year-old African-American Woman With Relapsed Multiple Myeloma
August 2015
A 55-year-old African-American woman presented to her PCP complaining of worsening fatigue, back pain, and bone pain
PMH: hypertension managed on a beta blocker, mild renal impairment
Laboratory results:
Hb, 11.0 g/dL;
Ca2+, 10.1 mg/dL;
Creatinine, 1.2 mg/dL;
M-protein, 0.9 g/dL
Β2M, 5.0 mg/L
Albumin, 2.9 g/dL
MRI showed multiple small lytic lesions in the T1/T2 vertebrae
Bone marrow biopsy confirmed the diagnosis of multiple myeloma; R-ISS stage II; t(4;14)
She was treated with lenalidomide/bortezomib/dexamethasone (RVd) for 6 months and achieved a VGPR
The patient was recommended for autologous transplant, however, she instead opted to continue on a de-escalated treatment regimen of Rd after stating that she struggled to maintain her treatment schedule