Transplant-Eligible Newly Diagnosed Multiple Myeloma
Transplant-Eligible Newly Diagnosed Multiple Myeloma
Case: 75-Year-Old Woman with Newly Diagnosed Multiple Myeloma
History and Presentation:
- 75-year-old woman; diabetic on metformin, no history of coronary artery disease or other comorbidities
- κ light chain multiple myeloma diagnosed November 2019
- Durie-Salmon Stage IIIA, ISS Stage 2
- Laboratory findings
- Total proteinuria 5.82 g/day
- Bence Jones protein (BJP) 3.6 g/day
- Hypogammaglobulinemia
- Albumin 3.9 g/dL
- β2-microglobulin 4.7 mg/L
- Creatinine 1.7 mg/dl
- No paraprotein peak but kappa light chain 2000 with lambda light chain at 1
- Kappa/lambda ratio=2000
- Bone marrow biopsy
- Cellularity 25% with 80% plasma cells
- Cytogenetics 46, XX
- FISH no abnormalities
- Imaging
- Skeletal survey: extensive lytic bone disease with healing fractures of left 7thand the 8thribs
- MRI of the spine: multiple compression fractures
- MRI of the pelvis: diffuse marrow infiltrative changes due to myeloma
- Cytogenetics/FISH: no adverse cytogenetics
- ECOG PS: 1
- Patient was started on D-VRd
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