High-Risk Nonsecretory Multiple Myeloma With Poor Response to Daratumumab-Based Chemotherapy

Nonsecretory multiple myeloma (NSMM) is the variant of multiple myeloma defined by no detectable M protein secretion in serum or urine electrophoresis. Due to the lack of detectable M spike, diagnosis is often challenging and relies on bone marrow studies. As studies specifically focusing on NSMM are lacking, the current treatment guidelines are based on studies in secretory multiple myeloma. In this case report, we describe a 77-year-old female patient with a typical presentation of NSMM who did not respond to a chemotherapy regimen based on daratumumab.