NDMM at EHA 2024

CME

Experts Discuss Advances in Newly Diagnosed Multiple Myeloma: The Impact of More Intensive Therapy on Clinical Outcomes

Physicians: Maximum of 1.50 AMA PRA Category 1 Credits

Released: September 17, 2024

Expiration: September 16, 2025

Michele Cavo
Michele Cavo, MD
Francesca Gay
Francesca Gay, MD, PhD
Paul G. Richardson
Paul G. Richardson, MD

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Rate your level of agreement with the following statement. I am very confident in my ability to identify patients with NDMM who are most likely to benefit from a CD38 mAb-based quadruplet regimen.

2.

Patient Case: Newly Diagnosed Multiple Myeloma



  • A 55-yr-old woman with no significant past medical history presents with worsening lower back pain

  • Initial evaluation includes plain films that show multiple lytic lesions in the vertebrae with an associated compression fracture at L1; initial labs are notable for Hb 9.8 g/dL, albumin 3.1 g/dL, total protein 9.0 g/dL, serum Cr of 0.8 g/dL, Ca 11.0 mg/dL

  • Additional evaluation

    • SIFE/SPEP: IgA lambda monoclonal protein 3.5 g/dL  

    • IgG 400, IgA 3700, IgM 20, kappa 5.1 mg/L, lambda 267 mg/L, FLC ratio 0.019

    • LDH 400 (elevated); serum β2-microglobulin is 7.1 mg/L

    • PET/CT scan: multiple hypermetabolic areas in the bones with associated lytic lesions

    • Bone marrow biopsy: 45% atypical plasma cells; FISH (CD138+ selected): gain 1q positive and t(4;14)



In your current clinical practice, what would you recommend for this patient? 

3.

In the phase III PERSEUS trial evaluating Dara-VRd and Dara-R maintenance vs VRd and R maintenance in ASCT-eligible patients with NDMM, all of the following are true regarding the addition of daratumumab EXCEPT:

4.

In the phase III IsKia EMN24 trial evaluating the addition of isatuximab to KRd in ASCT-eligible patients with NDMM, which of the following best describes the impact of isatuximab on MRD? 

5.

Patient Case 2: Newly Diagnosed Multiple Myeloma



  • 76-yr-old male with history of COPD (well-controlled) and low back pain x10 yr after motor vehicle accident presents with increased fatigue

  • Exam shows: 

    • Anemia with Hgb 9.7 g/dL

    • Serum electrophoresis: M-spike: 4.2 g/dL, IF: IgG K

    • Bone marrow aspirate: 30% plasma cells

    • Cytogenetics (FISH): t(14;16); TP53 mutation

    • Low-dose whole-body CT: diffuse bone lesions, spine

    • Creatinine: creatinine clearance 30 mL/min; β2 microglobulin: 2.5 mg/L; albumin: 3.8 g/dL;  LDH normal



In your current clinical practice, which treatment would you recommend for this patient? 

6.

In a global analysis, which of the following sociodemographic factors was NOT found to be associated with worse access to treatment for patients with multiple myeloma?