The treatment of multiple myeloma has progressed by leaps and bounds in the last decade, and the goals of our treatment are: to achieve disease remission, prevent any complications and maintain quality of life, and prolong progression-free survival and overall survival of patients. However, multiple myeloma is still an incurable disease that always recurs, so what are our options after disease recurrence or progression? Patient Zhang, male, 63 years old Complaint: diagnosed multiple myeloma for more than 3 years Past history: The patient was diagnosed with lumbar disc herniation outside the hospital a year ago, and the specific treatment is unknown. Diagnosed diabetes mellitus years ago, now taking oral Damacell and Bystolic. Poor control. Biopsy pathology diagnosed L1 vertebral body plasmacytoma. Monoclonal k light chains were found in blood and urine, and 24-hour urine light chains were Bone marrow smear plasma cells 7%. Hemoglobin 121g/L, albumin 36.2g/L, globulin Creatinine 67.0μ Blood β2 microglobulin Diagnosis of multiple myeloma KAP light chain type was confirmed Regimen bortezomib 1.3mg/m2 d1, 4, 8, 11. Dexamethasone 10mg d1, 2, 4, 5, 8, 9, 11, 12 Complete remission (CR) was achieved after 2 courses of induction. This was followed by maintenance with interferon and regular review (Note: the dose of glucocorticoids at the time of chemotherapy was adjusted due to the patient’s history of diabetes and consistently poor glycemic control) The regimen was well tolerated by the patient, with no uncontrollable toxicities. (No peripheral neuropathy.) Blood β2 microglobulin 5.8500mg/L; bone marrow smear 25% plasma cells, some morphologically naive Monoclonal k light chain detected in blood and urine Suggestions: C3, T2-3, L4, sacrum, bilateral scapulae, bilateral clavicles, sternum, bilateral multibranch ribs, bilateral humerus, pelvis and bilateral femurs were seen more foci of increased 18F-FDG uptake with a maximum SUV of 6.3, CT showed Osteolytic bone destruction was seen in some of these areas. Consider disease recurrence (analysis: patient did not undergo cytogenetic testing (FISH) for economic reasons, based on the patient’s efficacy at initial induction and side effects, consider the option of applying a regimen containing bortezomib for treatment) Regimen chemotherapy: Vanco 1.3mg d1, 4, 8, 11. Dexamethasone 15mg d1, 2, 8, 9, 15, 16, 22, 23. After a course of treatment to achieve Complete remission Guidelines recommend: MM patients can continue treatment with the original regimen after relapse