case_images: PMC4427147_01
case_images: Cytomorphology of a bone marrow aspirate smear (x63) performed in August 2010 showing high-grade diffuse infiltration with atypical plasma cells.
case_images: cro-0008-0189-g01.jpg
case_images: PMC4427147_01_cro-0008-0189-g01.jpg
case_images: F1
case_images: With high-grade plasma cell infiltration of the bone marrow (fig. 1), increasingly severe pancytopenia developed, causing chronic fatigue and impaired quality of life and eventually led to treatment discontinuation.
case_images: Disease course based on M protein levels indicated in months after primary diagnosis (DX). Benda = Bendamustine; Len = lenalidomide; Dex = dexamethasone; Bort = bortezomib; Cyclo = cyclophosphamide; Mel = melphalan; Poma = pomalidomide; VCD = bortezomib/cyclophosphamide/dexa-methasone.
case_images: cro-0008-0189-g02.jpg
case_images: PMC4427147_01_cro-0008-0189-g02.jpg
case_images: F2
case_images: In August 2010, at the age of 68 and 8 years after primary diagnosis (fig. 2), we started treatment with pomalidomide (4 mg days 1-21 of a 28-day cycle) and low-dose dexamethasone (40 mg weekly) in combination with doxorubicin (4 mg days 1-4 by continuous infusion).
case_images: Radiograph of a pathological humeral fracture corresponding to serological disease progression in June 2011. Imaging after osteosynthesis with a proximally and distally fixed intramedullary nail.
case_images: cro-0008-0189-g03.jpg
case_images: PMC4427147_01_cro-0008-0189-g03.jpg
case_images: F3
case_images: Five months after the interruption of antimyeloma treatment, the patient suffered from serological disease progression and a pathological humeral fracture requiring surgical treatment (fig. 3).