Multiple myeloma (MM) during pregnancy is rare, with only 45 cases reported between 1965 and 2020. In the presented case, a 40-year-old woman was diagnosed with oligosecretory IgG kappa MM at 16 weeks of pregnancy after developing elevated blood pressure and renal dysfunction. Initially, her symptoms were attributed to pregnancy, delaying diagnosis. Once confirmed, treatment was initiated with high-dose dexamethasone and cyclophosphamide to control the disease while maintaining fetal safety, ultimately leading to the delivery of a healthy baby at 36 weeks via caesarean section.

MM therapies during pregnancy must balance disease control with fetal safety. In this case, the patient’s treatment with dexamethasone and cyclophosphamide managed the MM without affecting the baby’s health. After delivery, more aggressive treatment with bortezomib, lenalidomide, and dexamethasone was introduced, followed by a successful stem cell transplant. This case highlights the importance of early diagnosis and the careful management of MM during pregnancy to optimize both maternal and fetal outcomes.

Reference: Magen H, Simchen MJ, Erman S, Avigdor A. Diagnosis and management of multiple myeloma during pregnancy: case report, review of the literature, and an update on current treatments. Ther Adv Hematol. 2022;13:20406207211066173. doi: 10.1177/20406207211066173.