The Changing Landscape of Myeloma Therapy

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Abstract
The introduction of melphalan and prednisone for the treatment of multiple myeloma was followed by only minor advances in the management of the disease for almost 20 years.1 The failure of other agents, alone or in combination, to extend survival beyond three years prompted a new treatment strategy in the early 1980s: myeloablative doses of melphalan supported by an infusion of autologous hematopoietic stem cells. After this approach was found to be superior to conventional chemotherapy for the initial treatment of myeloma, the efficacy of two sequential courses of high-dose therapy, each supported by an infusion of autologous stem cells, . . .