Extramedullary Myeloma to the Liver Following Bispecific Antigen T-Cell Treatment for Refractory Multiple Myeloma
Bibliographic record
Abstract
A 70-year-old man diagnosed with refractory multiple myeloma was admitted to hospital for an elevation in his liver enzymes. In the 7 years since diagnosis, he had undergone 8 chemotherapy regimens, an autologous stem cell transplant, and palliative chemotherapy to his T-spine. He was now undergoing bispecific antigen T-cell treatment with the elevation in his liver enzymes occurring 2 days after his initial treatment. He underwent liver imaging as part of his workup. Previous CT scans of his abdomen showed a normal liver in May 2020, and in October 2020, they showed a nonspecific hypoattenuation in the inferior right hepatic lobe. A whole-body PET/CT was done and, in addition to multiple bone lesions to ribs, T-spine, and long bones, showed multiple fluorodeoxyglucose avid liver masses measuring 11 × 3 cm (Figures A–D). A contrast-enhanced ultrasound confirmed the presence of multiple solid liver masses with malignant enhancement characteristics in keeping with plasmacytomas (Figures A–D). MRI of his liver showed identical signal characteristics and enhancement pattern compared to extensive pleural and chest wall and paravertebral masses consistent with plasmacytoma (Figures A–D). The bispecific antigen T-cell treatment was subsequently discontinued. Unfortunately, the patient had progressive renal failure and died approximately 1 month later.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".