A 74-year-old woman presented with anemia, proteinuria, renal insufficiency, and pain in her right hip History: chronic HTN, aortic insufficiency, diabetes mellitus ECOG performance status, 1 X-Ray of the pelvis showed numerous lytic lesions in the ilium and a large lesion in the right proximal femur MRI confirmed a 9-mm lesion in the right femoral head and numerous bilateral T1 hypointense and T2 hyperintense lesions in both iliac region Laboratory results: Hb, 10.1 g/dL Ca2+3.32 mmol/L Creatinine, 1.9 mg/dL Creatinine clearance, 30 mL/min M-protein, 1.4 g/dL B2M, 4.9 mcg/mL SFLC, kappa, 150 mg/dL Bone marrow biopsy, 70% plasma cells Molecular testing, del17p