What is your preferred first line regimen for myeloma with severe renal impairment, either on or off dialysis?

In general, for patients with renal insufficiency related to their myeloma, time is nephrons. So the earlier you can correct the hypercalcemia, lower circulating uric acid, stop ongoing bad behaviors (NSAID overuse, etc), and treat the myeloma, the better.

If the patient is admitted, I will give pa...