Multiple Myeloma in Young pregnant Patient

Background: Multiple Myeloma (MM) is a relatively uncommon cancer that accounts for approximately 10 percent of all hematologic malignancies. It is an incurable disease and is behind about 20 percent of mortality from hematologic malignancy and 2 percent of mortality from all cancers. MM is usually characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. The plasma cells proliferate in the bone marrow and can result in extensive skeletal destruction with osteolytic lesions, osteopenia, and /or pathologic fractures. MM is rarely seen in those younger than 35 years old. Despite those in the younger age group having been shown to have a more aggressive course, reportedly they have had similar responses to treatment compared to older patients. Case: This case is about a young pregnant female who presented to the hospital with body ache and diplopia in her 30th week of pregnancy. Multiple Myeloma type IgA lambda was diagnosed. The baby was delivered prematurely but healthy. The patient was treated initially with bortezomib, cyclophosphamide, and dexamethasone (VCD) regimen along with radiation therapy and chemotherapy. The patient responded well to the treatment. Conclusion: This case of Multiple Myeloma in a young pregnant female presented with unexplained symptoms and was diagnosed after presentation with neurological symptoms. Treatment with VCD regimen along with radiation therapy and chemotherapy showed excellent response. It highlights that multiple myeloma may present atypically in young patients and early diagnosis is important. The Case report is needed.to determine optimal treatment regimens for this subset of young patients.