Background: Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Each year over 32,000 new cases are diagnosed in the United States, and almost 13,000 patients die of the disease. The annual age-adjusted incidence in the United States has remained stable for decades at approximately 4 per 100,000. Multiple myeloma is slightly more common in men than in women, and is twice as common in African-Americans compared with Caucasians. The median age of patients at the time of diagnosis is about 65 years. Traditional diagnostic criteria for the diagnosis and indications for the introduction of therapy in myeloma have defined active myeloma by the presence of end organ effects. These have now been expanded by the International Myeloma Working Group from the analysis of the risk of progression in large cohorts of patients with smouldering multiple myeloma. These new criteria have extended the diagnostic criteria to include the presence of free light chain abnormality(ratio of involved free light chain to non-involved free light chain > 100 mg/L; reference interval, 0.26–1.65 mg/L), bone marrow involvement demonstrating more than 60% plasma cells and the presence of more than one lytic lesions on magnetic resonance imaging (MRI) scan, in addition to the previous standard criteria. Patients with a clonal plasma cell disease and signs of manifest or threatened organ damage must receive adequate systemic therapy. Although this does not generally lead to cure, modern treatment plans have now increased the 5-year survival rate for myeloma patients up to 75 years of age to over 50%. In3–20% of patients, complete remission can last for many years. In the absence of severe (cardiac and pulmonary) comorbidities, the standard treatment in Germany remains high-dose melphalan (200 mg/m2)followed by retrains fusion of autologous blood stem cells.