Treatment of Multiple Myeloma with High-Risk Cytogenetics
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
May 2018
- M-protein, May 1.5 g/dL
June 2018
- M-protein, 1.7 g/dL
July 2018
- MRI, no new lytic skeletal lesions
- Laboratory results:
- Hb, 11.5 g/dL;
- Ca2+, 9.8 mg/dL;
- Creatinine, 1.1 mg/dL;
- M-protein, 1.9 g/dL
- Β2M, 4.2 mg/L
- ECOG PS: 0
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