A Trial Comparing Single Agent Melphalan to Carmustine, Etoposide, Cytarabine, and Melphalan (BEAM) as a Preparative Regimen for Patients With Multiple Myeloma Undergoing High Dose Therapy Followed by Autologous Stem Cell Reinfusion

Inclusion Criteria

• •1. Patients who have a new diagnosis of MM according to the International Myeloma Working Group (IMWG) working criteria undergoing autologous or syngeneic hematopoietic transplantation
• •According to these criteria, the following must be met:
• •1. Monoclonal plasma cells in the bone marrow \> 10% (or proven plasmacytic infiltration in bone marrow biopsy) and/or presence of a biopsy-proven plasmacytoma.
• •2. Monoclonal protein (M-protein) present in the serum and/or
• •3. Myeloma-related organ dysfunction (1 or more) of the following. A variety of other types of end-organ dysfunctions can occasionally occur and lead to a need for therapy: - \[C\] Calcium elevation in the blood, defined as serum calcium \> 10.5 mg/dl or upper limit of normal \[R\] Renal insufficiency (defined as serum creatinine above normal) \[A\] Anemia, defined as hemoglobin \< normal - \[B\] Lytic bone lesions or osteoporosis. If a solitary (biopsy-proven) plasmacytoma or osteoporosis alone (without fractures) are the sole defining criteria, then \> 30% plasma cells are required in the bone marrow
• •2. Patients must have received initial therapy for MM; at least 2 cycles with a minimum of partial response as defined by IMWG guidelines.
• •3. Age \>=18, \< 70years.
• •4. Karnofsky \>70.
• •5. Life expectancy is not severely limited by concomitant illness based on the Hematopoietic Cell Transplant Comorbidity Index (HCT-CI) \[8, 9\] including:
• •1. Left ventricular ejection fraction \>50%. No uncontrolled arrhythmias or symptomatic cardiac disease.
• •2. FEV1, FVC and DLCO \>50%. No symptomatic pulmonary disease.
• •3. HIV-negative.
• •4. Bilirubin \<2 mg/dl, SGPT \<2.5 x normal.
• •5. Creatinine clearance \> 50 cc/min, estimated or measured.
• •6. Proficient in English
• •7. Signed informed consent