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Introduction Multiple myeloma (MM) is a complex plasma cell malignancy characterized by clonal proliferation and monoclonal immunoglobulin production. Despite the availability of several prognostic markers for MM, many are challenging to implement routine clinical practice due to cost, complexity, or lack of standardization. Red cell distribution width (RDW), a cost-effective and routinely measured parameter in complete blood counts, has gained increasing attention as a prognostic marker due to its association with disease severity and outcomes in MM.

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Patients with multiple myeloma (MM) often experience infections due to aberrant immunoglobulin production by malignant plasma cells and immunosuppressive therapeutic interventions that are used to treat the condition. A rare but serious infection that may occur in these patients is Cryptococcus, an encapsulated fungus that typically infects immunocompromised individuals. Cryptococcus infections often present as pneumonia but can disseminate to the central nervous system, potentially causing meningitis.

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Bispecific antibodies (BsAbs) have emerged as crucial therapeutic agents for patients with relapsed/refractory diffuse large B-cell lymphoma, multiple myeloma, and most recently, lung cancer. These therapies have demonstrated remarkable efficacy in clinical trials; however, multidisciplinary collaboration is essential to ensure optimal patient outcomes amid the operational complexities associated with BsAb therapy. As BsAbs are being prepared for broader adoption, clinicians and treatment centers must navigate operational challenges, including financial considerations, patient selection, caregiver involvement, and transitions of care.

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Background: This analysis explored real-world characteristics, treatment patterns and clinical outcomes in patients with relapsed or refractory multiple myeloma (RRMM) previously treated with lenalidomide and an anti-CD38 monoclonal antibody (mAb) and requiring subsequent treatment.

Materials And Methods: The PREAMBLE and Connect MM prospective registries of patients with multiple myeloma (MM), and the US nationwide Flatiron Health electronic health record-derived de-identified database were analysed. MM-specific treatment patterns (prior/index therapies) and outcomes (progression-free survival [PFS]/overall survival [OS]) were assessed.

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The case report presents a male patient in his mid-60s with a history of hypertension, benign prostatic hyperplasia and chronic kidney disease (CKD). He presented with gradually increasing serum creatinine levels and hyperglobulinemia, leading to suspicion of multiple myeloma. However, subsequent testing revealed features consistent with systemic lupus erythematosus (SLE) and IgG4-related kidney disease (IgG4-RKD).

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