We present a case of 71-year-old man…who was initially diagnosed with CML....The cytogenetic analysis revealed the presence of an uncommon three-way translocation 46,XY,t(4;9;22)(q21;q34;q11)...Treatment with tyrosine kinase inhibitor (TKI), nilotinib (300mg bid), was started and the patient achieved a complete hematologic response and at 3 months – complete cytogenetic response with normal bone marrow karyotype and early molecular response. MM was diagnosed, in addition to CML. Chemotherapy with weekly bortezomib, cyclophosphamide and dexamethasone was preferred considering the risk of drug interactions and pancytopenia when combined with nilotinib for CML. The patient achieved complete response with 6 courses of chemotherapy for MM, deep molecular response (DMR) of CML at the first year of TKI therapy.