INTERNATIONAL STAGING SYSTEM; RANDOMIZED PHASE-III; WORKING GROUP; CELL TRANSPLANTATION; INITIAL TREATMENT; DEXAMETHASONE; LENALIDOMIDE; BORTEZOMIB; TRIAL; THERAPY

Multiple myeloma (MM) accounts for 1% of all cancers and ??10% of all haematological malignancies. The incidence in Europe is 4.5?6.0/100 000/year with a median age at diagnosis of 72 years; the mortality is 4.1/100 000/year [1]. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1% per year. In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) MM (SMM) can be recognised. SMM progresses to myeloma at a rate of 10% per year over the first 5 years following diagnosis, 3% per year over the following 5 years, and 1.5% per year thereafter [2].