MM-066 Multiple Myeloma Diagnosis After Pathological Fracture of Femur

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2024-09, Vol.24, p.S534-S534
• Main Authors: Komani, Gjon, Rrusta, Shpat, Gashi, Fitim, Krasniqi, Erkan, Ukimeraj, Arferdita, Krasniqi, Vjosa
• Format: Article
• Language: English
• Subjects: CyBorD; osteolytic lesions; plasma cells
• ISSN: 2152-2650
• DOI: 10.1016/S2152-2650(24)01638-0

Multiple myeloma (MM) is a clonal B-cell malignancy characterized by proliferation of plasma cells that accumulate mainly within bone marrow (BM) and usually secrete monoclonal immunoglobulin or immunoglobulin light chain. It is a disease that causes significant morbidity and mortality in the population. With this case report study, we sought to better understand the clinical presentation and characteristics of MM. The data was collected from the patient files in the Hematology Clinic of the University Clinical Center of Kosovo. The main outcome measure was chemotherapy treatment results. A male patient, age 70, presented to the ER with a fracture of the diaphysis of the right femur after a fall. During osteosynthesis surgery, a bone fragment was sent for histopathological and immunohistochemical analysis, and MM was diagnosed. Laboratory results: ESR, 98 mm/h; WBC, 6.3 x 1000/mm3; RBC, 3.65 x 1,000,000/mm3; Hb, 10.7 g/dL; Hct, 35.6%; Plt: 133 x 1,000/mm3. Metabolic panel: urea, 6.94mmol/L; creatinine, 121.8 μmol/L; total protein, 116.7 g/L; albumin, 29.9 g/L; LDH, 135 U/L; CRP, 3.1 mg/L. Serum protein electrophoresis: M peak. Immunoglobulins: IgG, 5.47 g/L; IgM, 0.08 g/L; IgA, 0.10 g/L; kappa, 0.7 g/L; lambda, 0.08 g/L. Additional measures: calcium, 2.66 mmol/L and beta-2-microglobulin, 6.26 g/L. Bone marrow aspirate showed plasma cell infiltration around 40%. Skull x-ray found osteolytic lesions. International staging system was stage III. Internal osteosynthesis of the femur diaphysis fracture was realized. The patient was treated with chemotherapy on the bortezomib, cyclophosphamide, and dexamethasone (VCD or CyBorD) protocol for 8 cycles. He is now on maintenance therapy with bortezomib every 2 weeks.