Multidisciplinary approach in therapy of newly diagnosed multiple myeloma complicated by compression fracture of the Th2 vertebral body with neurologic deficit. Clinical observation

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Abstract

The use of highly effective combinations of pharmaceutical agents in the 1st line therapy of multiple myeloma promotes higher survival in all patient subgroups including high-risk patients. The presence of bone plasmacytoma with soft tissue components and spinal cord compression, pathological compression fractures of vertebral bodies worsen prognosis by increasing the probability of neurologic deficit development and quick progression at any stage. Therefore, the use of multidisciplinary approach is justified.
A clinical observation of a 65-year-old patient with multiple myeloma manifesting through bone plasmacytomas with massive soft-tissue components and complicated by pathological compression fracture of the Th2 vertebra with neurologic deficit is presented. After the appearance of clinical symptoms of compression, surgical intervention was urgently performed (decompression laminectomy, subtotal resection of the tumor at the Th2–Th3 vertebra level) with partial mobilization of the patient in the early postoperative period. Antitumor drug therapy was started (daratumumab, lenalidomide, dexamethasone – D-Rd regimen) demonstrating positive effect.

About the authors

M. M. Davydov

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0001-5038-9307

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

Yu. E. Ryabukhina

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

Author for correspondence.
Email: gemonk.yur@mail.ru
ORCID iD: 0000-0001-8443-8816

Yulia Evgenyevna Ryabukhina 

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

R. L. Kambiev

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0003-3694-4698

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

V. N. Rashidov

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0009-0008-7692-2091

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

K. M. Kulakov

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0009-0007-5831-7288

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

A. V. Meladze

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0009-0007-0815-0627

Bld. 2, 8 Trubetskaya St., Moscow 119991 

Russian Federation

P. A. Zeynalova

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies ; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0003-1564-424X

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Bld. 2, 8 Trubetskaya St., Moscow 119991 

Russian Federation

O. L. Timofeeva

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies

ORCID iD: 0000-0002-6229-7300

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081 

Russian Federation

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