Clinical response of patient to treatment with TCD or VCD regimen. (A, B) The disappearance of cyanosis from the patient’s hands (A) and telangiectasias from her arm (B) after treatment with 3 cycles of VCD regimen. (C) Computed tomography scans of abdomen showing resolution of perinephric fluid collections after treatment with TCD and VCD regimen. (D) ^99mTc-labeled macroaggregated albumin lung perfusion scintigraphy showing the decrease of intrapulmonary shunting after treatment with 3 cycles of VCD regimen (right side). The presence of intrapulmonary shunting was evidenced by the tracer uptake over the brain, liver, spleen, and kidneys in addition to the lungs. (E) Trend of hemoglobin (upper), erythropoietin (middle), and serum M-protein levels (lower) after treatment with TCD and VCD regimen.