Excerpt

A 51-year-old African-American male with a history of relapsed refractory IgA lambda myeloma status post stem cell transplant and many salvage therapies was referred to the nuclear cardiology laboratory in June 2015 for equilibrium radionuclide ventriculography (multigated acquisition; MUGA) to evaluate left ventricular function since he was recently started on a new regimen, which includes the mitogen-activated protein kinase kinase inhibitor trametinib, a potentially cardiotoxic chemotherapeutic agent. His diagnosis of multiple myeloma was first made 7 years prior to presentation to the nuclear lab; at that time he had presented with anemia, hypercalcemia, back pain, lytic bone lesions on CT scan, and markedly elevated total protein and low albumin. Bone marrow biopsy confirmed the suspicion of multiple myeloma. He was initially seen at a local office and subsequently referred to a quaternary care center drawing myeloma patients from across the United States and internationally, for further management of IgA kappa myeloma. …