A 70-year-old woman with high-risk IgGλ multiple myeloma (t (14;16) translocation), previously treated with multiple lines of therapy, was started on carfilzomib and pomalidomide for a clinical relapse. One month later, she presented with new-onset fatigue, decreased urine output, and bilateral lower extremity swelling. On examination, blood pressure was 158/94 mm Hg, heart rate 98 beats per minute, and 1+ pitting edema was noted on bilateral lower extremities. Cardiopulmonary and abdominal examination was unremarkable.