[The general management of multiple myeloma--risk factor]

The introduction of melphalan therapy produced improvement in either response rates or survival of patients with myeloma. Since then, many attempts have been carried out to improve the results achievable with MP therapy by the use of combination chemotherapy, but no difference in survival was found. Recent efforts have evaluated dose intensification for patients with good risk factor to from the viewpoint of bone marrow ablation requiring hematopoietic stem cell support, though these approaches may be ineffective for patients with refractory myeloma.