Total Marrow Irradiation With High Dose Melphalan Prior to Autologous Transplant for Relapsed or Refractory Multiple Myeloma (BMT-03)

Inclusion Criteria:

1. Patients meeting criteria for symptomatic myeloma

2. Patients who have progressive myeloma following initial induction (patients may have
received any number of treatment regimens including prior autologous transplant)

3. Patient age 18-75 years at time of enrollment

4. Karnofsky performance status of ≥70

5. Cardiac function: LVEF >40%

6. Hepatic: Bilirubin <2x upper limit of normal and ALT and AST < 2.5x the upper limit of
normal

7. Renal: Creatinine clearance of >30mL/min, estimated or calculated

8. Pulmonary: DLCO, FEV1, FVC >50% of predicted (after correction for hemoglobin)

Exclusion Criteria:

1. Patients with diagnosis of plasma cell leukemia

2. Patients with truly non secretory myeloma (patients with light chain disease are
eligible)

3. Pregnant or breast-feeding

4. Uncontrolled viral, fungal or bacterial infection Note: Infection is permitted if
there is evidence of response to medication. Eligibility of HIV infected patients will
be determined on a case-by-case basis.

5. Patients who have undergone prior allogeneic stem cell transplant

6. Prior solid organ transplant

7. Patients receiving prior radiation to more than 20% of bone marrow containing areas