FRCPath Haem Part 1 MCQ-Oncology 427

A 66-year-old man is diagnosed with systemic progressive dyspnea and proteinuria 3+. Congo red stain positive. Bone marrow shows 12% clonal plasma cells. NT-proBNP is elevated, but he remains ambulatory with preserved performance status.

What is the most appropriate first-line treatment?

A. Cyclophosphamide, thalidomide, dexamethasone (CTD)

B. Bortezomib, cyclophosphamide, dexamethasone (VCD)

C. Daratumumab + VCD (Dara-VCD)

D. Lenalidomide + dexamethasone

E. High-dose melphalan with autologous stem cell transplant