You have undertaken a bone marrow biopsy and the aspirate (shown below) and flow are back.
There is a population of abnormal CD20+, CD38+, CD138+, CD56+ cells.
His calcium is a little better at 3.1 but his renal function is fairly static with a creatinine of 185 and urea 8.3.
LDH is normal.
What would be your choice of treatment?
What supportive management would you undertake along side this?
It’s a Friday evening and you can’t start definitive treatment until next week. Anything you want to do in the meantime?