Conventional Chemotherapy for Multiple Myeloma

Minimal criteria for the diagnosis of multiple myeloma con-sists of more than 10 % plasma cells in the bone marrow or a plasmacytoma and one of the following: 1) M-protein in the serum (usually> 3g/dL); 2) M-protein in the urine; or 3) lytic bone lesions. These findings must not be related to metastatic carcinoma, lymphoma, connective tissues disor-ders, or chronic infections. It is also necessary that the pa-tient have the usual clinical features of multiple myeloma. Monoclonal gammopathy of undetermined significance (MGUS)(1), smoldering multiple myeloma (SMM)(2) and pri-mary systemic amyloidosis (AL)(3) must be included in the differential diagnosis. The size of the M-protein in the se-rum and the urine and the number of bone marrow plasma cells are helpful in the differential diagnosis. In the asymp-tomatic patient, an M-protein value < 3g/dL, fewer than