Quiz: Thrombotic Microangiopathies in Multiple Myeloma

In this quiz, you’ll get a chance to test your knowledge on thrombotic microangiopathies in multiple myeloma. Here’s your first question:

1.  Patients with multiple myeloma who develop thrombotic microangiopathies (TMAs) experience irreversible end-organ damage and high risk of death if treatment is delayed.

A.True

B.False

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Answer: A.True. TMAs are associated with both irreversible end-organ damage and high risk of mortality if treatment is delayed.

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2.  TMAs can include or involve which of the following?

A.Atypical hemolytic uremic syndrome (aHUS)

B.Thrombotic thrombocytopenic purpura (TTP)

C.Microangiopathic hemolytic anemia (MAHA)

D.All of the above

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Answer: D. All of the above. TMAs are a group of thrombocytopenic syndromes that involve MAHA and include TTP and aHUS.

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3.  TMAs can be triggered by which of the following antimyeloma therapies?

A. Chimeric antigen receptor T-cell (CAR-T)

B.Bone marrow transplantation

C.Total body irradiation

D.All of the above

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Answer: B. Bone marrow transplantation. Transplant-associated TMA can be triggered by BMT.

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4.  Major risk factors for transplant-associated TMA include which of the following?

A.Grade 3-4 acute graft-versus-host disease (GVHD)

B.No total body irradiation

C.Female sex

D.All of the above

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Answer: D. All of the above. Major risk factors for transplant-associated TMA include grade 3-4 acute GVHD, no total body irradiation, female sex, unrelated donor, and sirolimus, cyclosporine, or tacrolimus.

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5. Poor prognostic factors for patients with multiple myeloma and transplant-associated TMA include which of the following?

A.LDH/platelets ratio ≥ 20

B.Decreased serum C5b-C9 levels

C.Platelets > 20 x 10⁹/L

D.All of the above

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A. LDH/platelets ratio ≥ 20. Poor prognostic factors for transplant-associated TMA include a TMA index (LDH/platelets ratio) of ≥ 20, platelets < 20 x 10⁹/L, elevated serum C5b-C9 levels, hemoglobin < 8 g/dL, elevated serum creatinine, and proteinuria ≥ 30 mg/dL.

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