This clinical vignette illustrates how our therapeutic approaches to early stages of multiple myeloma have changed over the past decade with novel therapies reducing disease and preventing disease progression. Recent paradigms of multiple myeloma describe the disease as a spectrum of clinical stages, including asymptomatic ‘smoldering’ states that progress to symptomatic states. The average 5-year survival rate of patients with multiple myeloma that was diagnosed between 1996-2004 according to SEER (Surveillance Epidemiology and End Results) data is 35.9%. Here we describe the use of novel therapeutic agents including bortezomib, lenalidomide, bisphosphonates, Doxil/Caelyx, and dexamethasone and their success in affecting the course of disease. Multiple trials have shown the increased benefit of these newer agents over prior multiple myeloma treatment regimens. At 13 years and 8 months from diagnosis, our patient is doing well and is a model of how long-term control of multiple myeloma prolongs survival.

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