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

The use of highly effective combinations of pharmaceutical agents in the 1^st 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.

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