Multiple Myeloma and Its Treatment

In 1995, Mr. F visited an emergency room with symptoms of an upper respiratory infection and severe rib pain induced by coughing. He was diagnosed initially with pneumonia and two fractured ribs; however, further workup revealed elevated serum creatinine, calcium, and protein levels and severe anemia (hemoglobin = 4.1 mg/dl). Malignancy was suspected, and additional diagnostic test results, including a serum immunoglobulin A (IgA) level higher than 7,000 mg/dl, led to the diagnosis of stage IIIB multiple myeloma (MM).