Plasma cell myeloma with predominant symptoms of bone disease-effective first-line treatment interrupted by low-energy pubic bone fracture — therapy complications management

Abstract

In the course of plasma cell malignancies, indications to start of treatment are often controversial from patient and guiding physician point of view. Diagnosis of smouldering myeloma, causes concerns about the late implementation of the proceedings with the effect of a worse prognosis and reduced quality of life of patient who developed tissue and organ damage in the further course of the disease. Myeloma defining events in the new International Myeloma Working Group (IMWG) criteria are the expression of those concerns. A case of 75 year old female patient with plasma cell myeloma, which was originally disqualified from treatment. Chemotherapy according to the VMP (vincristine, melphalan, prednisone) has been introduced when the bone complications, including fractures, appeared, which caused difficulties to proceed with the appropriate treatment. Patient with very good partial response is a subject to periodic follow-up.