Bone marrow and stem cell transplantation for multiple myeloma

  • David H. Vesole
Part of the Cancer Treatment and Research book series (CTAR, volume 99)


Multiple myeloma is an incurable B-cell malignancy afflicting mainly elderly people with a median age of 65 to 70 years [1]. It is characterized by the proliferation of clonal plasma cells that are resistant to standard doses of commonly employed agents at the time of diagnosis, resulting in complete remission (CR) rates of only 5%–10% and median survival of approximately three years. This inherent resistance is probably due to an array of molecular abnormalities of one or more oncogenes and suppressor genes inhibiting drug induced apoptosis, including ras, myc, p53, Rb, and bc1–2, that have evolved during a prolonged subclinical course of 10–20 years [2]. The recent report of a Kaposi sarcoma-associated herpes virus (KSHV) in the dendritic cells of myeloma patients, whose genome contains the homologue to human IL-6, suggests that the KSHV may also play an important role in the etiology of multiple myeloma [3]. A combination of melphalan and prednisone has been the standard treatment for over 30 years [4]. Permutations of the melphalan/ prednisone regimen by the addition of alkylating agents and anthracyclines have not extended the median survival [5].


Overall Survival Complete Remission Peripheral Blood Stem Cell Complete Remission Rate Autologous Peripheral Blood Stem Cell 
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© Kluwer Academic Publishers, Boston 1999

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  • David H. Vesole

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