Acquired von Willebrand syndrome associated with a smoldering multiple myeloma, successfully treated by daratumumab, lenalidomide and dexamethasone.

INTRODUCTION: Acquired von Willebrand syndrome (AvWS) is a rare entity with approximately 700 cases described in the literature. A number of etiologies are responsible for this condition, mainly lymphoproliferative, myeloproliferative syndromes and cardiac diseases. Management is aimed at preventing and treating bleeds, as well as treating the underlying pathology. In the case of a monoclonal gammopathy, there is limited evidence and high heterogeneity only based on old case reports, resulting in poor quality recommendations. It seems essential in 2023 to take into account and offer the new anti-myeloma treatments available. CASE PRESENTATION: We describe the case of a patient with an AvWS secondary to an IgG smoldering multiple myeloma, experiencing multiple bleeding, treated successfully with daratumumab, lenalidomide and dexamethasone, after multiples treatment failure. CONCLUSION: Daratumumab, lenalidomide, and dexamethasone demonstrated as a rapid and effective treatment for a patient with severe AvWS and multiple bleeding complications.