Quiz: Recognizing Comorbidities in Multiple Myeloma Patients

March 5, 2019

Are you aware of the common comorbidities seen in patients with multiple myeloma? Take our latest quiz to test your knowledge.

In our March multiple myeloma quiz, you'll get a chance to test your knowledge of common comorbidities in patients with multiple myeloma as well as considerations for management. Here's your first question:
 

1. Which of the following comorbidities is/are common among elderly multiple myeloma patients?

A.NeuropathyB.NephropathyC.Venous thromboembolismD.All of the above

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Answer: D. All of the above.  Common multiple myeloma–associated comorbidities in the elderly include neuropathy, nephropathy, venous thromboembolism, osteolytic bone lesions, elevated infection risk, hypercalcemia, and anemia.

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2. Incidence of which of the following comorbidities is elevated among elderly patients diagnosed with multiple myeloma?

A.Diabetes mellitusB.HypertensionC.Heart failureD.All of the above

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Answer: D. All of the above. Elderly patients with multiple myeloma have elevated rates of diabetes, hypertension, congestive heart failure, renal dysfunction, stroke, hyperlipidemia, and cardiac arrhythmias. These comorbidities must be considered when selecting antimyeloma treatment regimens because of the possibility of drug-drug interactions.

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3. Renal impairment is present in up to ___% of patients at the time of multiple myeloma diagnosis.

A.5%B.15%C.25%D.35%

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Answer: C. 25%. Between 20% and 25% of newly diagnosed patients with multiple myeloma also have renal impairment. More than half (55%) will develop renal impairment during antimyeloma treatment. Risk factors include multiple myeloma–associated hypercalcemia, amyloidosis, tumor lysis syndrome, advanced age, and exposure to nephrotoxic drugs.

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4. ______ regimens are a therapeutic mainstay for elderly multiple myeloma patients with renal impairment.

A.ThalidomideB.DenosumabC.BortezomibD.None of the above

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Answer: C. Bortezomib. Bortezomib-based regimens are a mainstay of treatment for patients with multiple myeloma and renal impairment because of how this therapy is metabolized in the liver, obviating the need for dose adjustments when renal impairment occurs.

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5. At the time of diagnosis, up to ___% of patients with multiple myeloma also have osteolytic bone disease.

A.50%B.60%C.70%D.80%

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Answer: D. 80%.  Osteolytic bone disease is already present at the time of multiple myeloma diagnosis in between 70% and 80% of patients, and it increases their risk of skeletal-related fractures or spinal compression. Bisphosphonates are used to reduce the risk of skeletal-related events; however, they increase the risk of osteonecrosis of the jaw.

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