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Medically, he was pale and febrile. Haemogram unveiled bicytopenia with leucocytosis. The peripheral blood film portrayed rouleax formation with 45% of circulating plasma cells. Serum protein electrophoresis and immunofixation unveiled IgG lambda paraproteinaemia of 48 g/L. Bone marrow aspirate, flow cytometry and trephine had been consistent with IgG lambda pPCL. He had been addressed with six cycles of bortezomib, thalidomide and dexamethasone combination chemotherapy followed closely by high-dose melphalan
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