An evidence-based approach to the management of newly diagnosed multiple myeloma, developed at the Mayo Clinic (Rochester, MN), is summarized in this article. The optimum pretransplant induction regimen for multiple myeloma is described, and outcomes for early and delayed transplantation, one versus two transplants, the role of thalidomide in smoldering multiple myeloma, and the role of maintenance therapy are discussed. The role of supportive care strategies for patients with bone disease, such as the use of bisphosphonates, is also discussed.
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