What is your approach to pRBC transfusion support for myeloma-related anemia?  

There is likely not a single right answer to this.The data suggests that a hemoglobin threshold of 7 g/dL is reasonable for critically ill patients rather than a higher threshold. The Clinical Practice Guidelines From the AABB recommend a threshold of 7-8 g/dL. In general, I follow these rules:...

For myeloma-related anemia, I tend to have a restrictive RBC transfusion threshold (Hb 7-8).  I use ESAs for chemotherapy-associated anemia when I can't dose reduce (e.g. monoclonal antibodies) or when drug dose is tied to efficacy and the patient is just getting started, e.g. proteasome inhib...

Very little that I'd add to the excellent answers by @Ben Derman and @Craig C. Hofmeister above. I will add that, when Hgb is disproportionately low compared to % plasma cells in the bone marrow, I suspect that inflammatory cytokines within the tumor microenvironment are driving the anemia more so t...