[Treatment of multiple myeloma with peripheral blood stem cell transplantation]

Dose intensive chemoradiotherapy with peripheral blood stem cell transplantation (PBSCT) has emerged as a useful treatment for patients with multiple myeloma. High-dose melphalan (140 mg/m2) combined with total body irradiation is usually an effective regimen for refractory myeloma. Based on the greater efficacy of the tandem autoplants with high-dose melphalan (200 mg/m2) for refractory myeloma, a similar approach is currently under investigation in untreated patients. A considerable relapse rate is still observed after high-dose chemoradiotherapy supported with PBSCT. It is unknown whether these relapses are the consequence of inadequate tumor reduction or tumor cells contamination in the grafts or a combination of both.