Talking Tumors: Exploring Management Strategies in Multiple Myeloma

Nina Shah, MD and Sandy Wong, MD, discuss the predictive value of minimal residual disease and the need for treatment in a patient with smoldering multiple myeloma.

This week, we spoke with Nina Shah, MD, an associate professor of medicine in the Department of Medicine at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, along with Sandy Wong, MD, an assistant clinical professor in the Division of Hematology/Oncology at the UCSF School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, to discuss the predictive value of minimal residual disease and the need for treatment in a patient with smoldering multiple myeloma.

In our discussion, Drs. Shah and Wong consider treatment for a standard-risk patient who maintained a very good partial response posttransplant but has minimal residual disease positivity, as well as the merits of observation versus treatment for a patient who is diagnosed with smoldering myeloma and does not meet the SLiM CRAB criteria indicating high-risk disease.

First, we hear from Dr. Shah, who shares a case of a 54-year-old man who presented with back pain and mild anemia. Listen on to hear the complete case presentation that led up to his diagnosis of revised International Staging System I multiple myeloma and a potential course of treatment.

Finally, Dr. Wong shares a case of a robust 77-year-old woman with no past medical history who presented with fatigue. Her workup revealed an IgG M-protein of 1 gram/dL and her bone marrow biopsy showed 10% kappa-restricted plasma cells. Listen on to hear the full case presentation that led up to her diagnosis of smoldering myeloma and the recommended course of care.

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