For the last 30 years, conventional dose melphalan and prednisone or corticosteroids alone at various dose levels have been the mainstay of treatment for patients with multiple myeloma.
Complete remissions are unusual, and few if any are cured with conventional therapy.
This has prompted the interest in studying high dose therapy which has demonstrated a higher incidence of complete remissions. The use of stem cell or bone marrow salvage, does allow the administration of high doses of chemotherapy in a relatively safe fashion. The advantage of this procedure is the use of uncontaminated bone marrow to salvage the recipient. The median age at diagnosis for patients with multiple myeloma is 70 years, while 55 is the usual upper age limit for allogeneic bone marrow transplantation in most transplant centers. In addition, most patients do not have syngeneic or suitable allogeneic donors.