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Background <p>Multiple myeloma (MM) in association with pregnancy is a rare event, and a consensus is lacking. It is urgent to increase the awareness of investigations required for a suspected diagnosis of MM during pregnancy and optimise its management.</p> Methods <p>A case of MM that occurred during pregnancy is presented with individual details, including clinical presentation, laboratory findings, diagnostic process, natural disease course, therapeutic approaches and outcomes. Afterwards, a literature search was conducted, and the available cases were descriptively reviewed.</p> Results <p>A 37-year-old pregnant woman was diagnosed with MM due to anaemia combined with other abnormalities, as revealed by laboratory tests performed during the second trimester. At 27 + 3 weeks gestation, the patient started chemotherapy with cyclophosphamide and methylprednisolone. She delivered a preterm infant via Caesarean section at 28 + 3 weeks gestation and continued to receive anti-myeloma therapy with standard induction postpartum, followed by autologous stem cell transplantation. Both the mother and her offspring achieved favourable outcomes. A total of 52 patients with MM associated with pregnancy aged between 21 and 44 years were identified from a literature review. Ten patients (19.2%) were diagnosed prior to pregnancy, 38 patients (73.1%) were diagnosed during pregnancy, and 4 patients (7.7%) were diagnosed postpartum. The most common initial complaint included bodily pain (53.8%), which was mostly attributed to bone lesions. Among the 48 patients diagnosed with MM before or during pregnancy, 25 patients (52.0%) received chemotherapy during pregnancy. Forty-seven patients (90.4%) delivered healthy infants, and all of them remained symptom-free up to the publication date. Forty-one women (78.8%) remained alive, whereas 10 women (19.2%) died.</p> Conclusion <p>Pregnant patients with MM exhibited a broad spectrum of manifestations. Clinicians should raise concerns and be aware of which investigations to request for a suspected diagnosis of MM. Prompt diagnosis in our patient ensured targeted monitoring, and an individualised strategy formulated by a multidisciplinary team allowed for acceptable maternal and foetal outcomes. Currently, multidisciplinary team work-up is preferable for management. The number of agents deemed to be safe for treating MM during pregnancy is fairly limited. Corticosteroids were observed to be the mainstay temporising treatment. Further research should focus on collaborative studies and be designed to assess novel therapies.</p>

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Successful management of a patient with multiple myeloma during pregnancy: a case report and literature review

  • 期刊论文

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  • 发表日期：

    2026年3月25日

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  • Xiangbo Lin,
  • Xiaoling Hu,
  • Qiwei Lin,
  • Wenwen Chen,
  • Yu Zhang

摘要

Background

Multiple myeloma (MM) in association with pregnancy is a rare event, and a consensus is lacking. It is urgent to increase the awareness of investigations required for a suspected diagnosis of MM during pregnancy and optimise its management.

Methods

A case of MM that occurred during pregnancy is presented with individual details, including clinical presentation, laboratory findings, diagnostic process, natural disease course, therapeutic approaches and outcomes. Afterwards, a literature search was conducted, and the available cases were descriptively reviewed.

Results

A 37-year-old pregnant woman was diagnosed with MM due to anaemia combined with other abnormalities, as revealed by laboratory tests performed during the second trimester. At 27 + 3 weeks gestation, the patient started chemotherapy with cyclophosphamide and methylprednisolone. She delivered a preterm infant via Caesarean section at 28 + 3 weeks gestation and continued to receive anti-myeloma therapy with standard induction postpartum, followed by autologous stem cell transplantation. Both the mother and her offspring achieved favourable outcomes. A total of 52 patients with MM associated with pregnancy aged between 21 and 44 years were identified from a literature review. Ten patients (19.2%) were diagnosed prior to pregnancy, 38 patients (73.1%) were diagnosed during pregnancy, and 4 patients (7.7%) were diagnosed postpartum. The most common initial complaint included bodily pain (53.8%), which was mostly attributed to bone lesions. Among the 48 patients diagnosed with MM before or during pregnancy, 25 patients (52.0%) received chemotherapy during pregnancy. Forty-seven patients (90.4%) delivered healthy infants, and all of them remained symptom-free up to the publication date. Forty-one women (78.8%) remained alive, whereas 10 women (19.2%) died.

Conclusion

Pregnant patients with MM exhibited a broad spectrum of manifestations. Clinicians should raise concerns and be aware of which investigations to request for a suspected diagnosis of MM. Prompt diagnosis in our patient ensured targeted monitoring, and an individualised strategy formulated by a multidisciplinary team allowed for acceptable maternal and foetal outcomes. Currently, multidisciplinary team work-up is preferable for management. The number of agents deemed to be safe for treating MM during pregnancy is fairly limited. Corticosteroids were observed to be the mainstay temporising treatment. Further research should focus on collaborative studies and be designed to assess novel therapies.