Quiz: Thrombotic Microangiopathies in Multiple Myeloma
How much do you know about thrombotic microangiopathies in multiple myeloma? Here's your chance to find out.
In this quiz, you’ll get a chance to test your knowledge on thrombotic microangiopathies in multiple myeloma. Here’s your first question:
1. Patients with multiple myeloma who develop thrombotic microangiopathies (TMAs) experience irreversible end-organ damage and high risk of death if treatment is delayed.
A.True
B.False
Answer: A.True. TMAs are associated with both irreversible end-organ damage and high risk of mortality if treatment is delayed.
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2. TMAs can include or involve which of the following?
A.Atypical hemolytic uremic syndrome (aHUS)
B.Thrombotic thrombocytopenic purpura (TTP)
C.Microangiopathic hemolytic anemia (MAHA)
D.All of the above
Answer: D. All of the above. TMAs are a group of thrombocytopenic syndromes that involve MAHA and include TTP and aHUS.
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3. TMAs can be triggered by which of the following antimyeloma therapies?
A. Chimeric antigen receptor T-cell (CAR-T)
B.Bone marrow transplantation
C.Total body irradiation
D.All of the above
Answer: B. Bone marrow transplantation. Transplant-associated TMA can be triggered by BMT.
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4. Major risk factors for transplant-associated TMA include which of the following?
A.Grade 3-4 acute graft-versus-host disease (GVHD)
B.No total body irradiation
C.Female sex
D.All of the above
Answer: D. All of the above. Major risk factors for transplant-associated TMA include grade 3-4 acute GVHD, no total body irradiation, female sex, unrelated donor, and sirolimus, cyclosporine, or tacrolimus.
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5. Poor prognostic factors for patients with multiple myeloma and transplant-associated TMA include which of the following?
A.LDH/platelets ratio ≥ 20
B.Decreased serum C5b-C9 levels
C.Platelets > 20 x 109/L
D.All of the above
A. LDH/platelets ratio ≥ 20. Poor prognostic factors for transplant-associated TMA include a TMA index (LDH/platelets ratio) of ≥ 20, platelets < 20 x 109/L, elevated serum C5b-C9 levels, hemoglobin < 8 g/dL, elevated serum creatinine, and proteinuria ≥ 30 mg/dL.
![“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.](/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fcancernetwork%2F70a5f0fed7009863fe30cf0740cf32014ebaf5be-2974x1660.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 "“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.")
![“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.](/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fcancernetwork%2F267879fc15a40ec8d3ed04d8ee9c1f044b49ee89-2990x1692.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 "“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.")
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