CD38 and BCMA in Multiple Myeloma

CME

Targeting CD38 and BCMA in Myeloma: Evidence and Enhanced Outcomes With Innovative Therapies

Physicians: Maximum of 1.50 AMA PRA Category 1 Credits

Released: August 09, 2024

Expiration: February 08, 2025

Craig Emmitt Cole
Craig Emmitt Cole, MD
Thomas G. Martin
Thomas G. Martin, MD
Noopur Raje
Noopur Raje, MD

Pretest

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

Patient Case: Newly Diagnosed Multiple Myeloma



  • 76-yr-old male with history of type II diabetes 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: CrCl 60 mL/min; β2-microglobulin: 2.5 mg/L; albumin: 3.8 g/dL; LDH normal



Which of the following would you recommend for this patient?

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 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-macroglobulin: 7.1 mg/L

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

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



What would you recommend for this patient?

3.

When counseling a patient on infection management strategies for a BCMA-targeting bispecific antibody, all of the following would be recommended EXCEPT: