58 yo female. i've been diagnosed with mds and smoldering myeloma. one oncologists says it's rare to have both. diangosis x 2yrs. pancytopenia. no tx yet.

Possible: Although not very common, it can happen. At this time, the standard of care for smoldering myeloma is still observational. For mild mds perhaps either just observe or blood transfusion as needed and growth support therapy as indicated. For intermediate-high risk mds- hypomethylating agent like vidaza or other agent like Revlimid (lenalidomide) will be considered depending on the cytogenetics. F/u with your md.

Rare: Although rare to have both diseases it can happen. Treatment of either disease will depend upon the symptoms. For smoldering myeloma most would monitor; for mds treatment depends upon frequency of transfusions, whether there are chromosomal abnormalities.