Treatment of Multiple Myeloma

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Abstract
Progress in the treatment of multiple myeloma has been disappointingly slow since the introduction of melphalan and cyclophosphamide more than two decades ago. In fact, not all patients who fulfill the minimal criteria for the diagnosis of multiple myeloma should be treated. Patients with smoldering multiple myeloma, which is characterized by an M protein level over 3 g per deciliter in the serum and more than 10 per cent atypical plasma cells in the bone marrow but no anemia, renal insufficiency, or osteolytic lesions, should be followed carefully and not treated unless progression occurs.1 The [3H]thymidine plasma-cell-labeling index is . . .