Autologous transplants for multiple myeloma

True complete remissions (CR) are achieved in less than 10% of patients treated for symptomatic disease, and their median survival does not exceed three years. This chapter reviews the currently available literature, focusing on the larger patient trials. Guidelines are provided for the optimal management of patients with Multiple myeloma (MM), and future avenues of potentially fruitful investigations are also delineated. Worldwide, more than 1, 000 patients have undergone autologous transplants for MM during various stages of their disease. An important consideration for auto transplants pertains to the availability of adequate hemopoietic stem cells. With currently available techniques, autologous and allogeneic transplants induce comparable CR rates of about 40%, especially when applied within 12 months from initiation of standard therapy. Controlled randomized trials comparing autotransplants and standard therapy are in progress in France and in the United States. A trial has been initiated at our institution with both autologous and allogeneic transplantation including idiotype vaccination.