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Multiple Myeloma in a Young Female Presenting with Neurological Symptoms
Matthew Lee1, Xinmin Zhang2, Vinh Nguyen3
1Internal Medicine Resident, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Dr, Manhasset, NY 11030, USA.
Background:
Multiple myeloma is overall the 14th most common malignancy but is rarely seen in those younger than 35 years. Those in the younger age group have been shown to have a more aggressive course but reportedly have had similar responses to treatment compared to older cohorts. Extramedullary plasmacytomas are discrete soft tissue masses of neoplastic monoclonal plasma cells that often occur in patients with multiple myeloma.
Case:
This case entails a young female with new diagnosis of multiple myeloma and multiple extramedullary plasmacytomas presenting with neurological symptoms. She was treated with CyBorD regimen but was refractory and progressed. Treatment was changed to DCEP regimen, and daratumumab was added for primary refractory myeloma. The patient improved rapidly.
Conclusion:
This is a unique case of multiple myeloma in a young female that had failed first-line treatment but responded to targeted therapy of daratumumab. It highlights that multiple myeloma may present atypically in young patients. More research is needed on appropriate initial diagnosis and treatment of patients in this age group.
Insights
This case study presents a young female with multiple myeloma and extramedullary plasmacytomas. She responded well to targeted therapy with daratumumab after initial treatment failure.
Area of Science:
- Hematology
- Oncology
- Clinical Case Study
Background:
- Multiple myeloma, a rare malignancy in individuals under 35, can present aggressively.
- Extramedullary plasmacytomas are neoplastic plasma cell masses often associated with multiple myeloma.
Observation:
- A young female diagnosed with multiple myeloma and extramedullary plasmacytomas presented with neurological symptoms.
- Initial treatment with CyBorD regimen resulted in refractory disease and progression.
Findings:
- The patient showed rapid improvement after switching to the DCEP regimen with the addition of daratumumab.
- This case highlights a successful response to targeted therapy in primary refractory multiple myeloma.
Implications:
- Multiple myeloma can manifest atypically in younger patients, necessitating tailored diagnostic and treatment approaches.
- Targeted therapies like daratumumab may offer effective treatment options for refractory multiple myeloma in young adults.
