The evolving background for high-dose treatment for myeloma.

In the constantly evolving field of myeloma, this special issue is slanted towards how the newer targeted treatments fit in with various transplantation strategies. High-dose treatment for myeloma with autologous stem cell transplantation started 25 years ago, with the consequence of producing complete remissions and a doubling of survival. Since then, its role has been refined and it has been accepted as standard treatment. The current challenge is to optimize its use into a background of the development, availability and regulatory approval of newer targeted therapies such as Thalidomide, Revlimid (Lenalidomide) and Velcade (Bortezomib). This special issue addresses these problems, and gives particular emphasis on the attainment of very long-term survival, with normal quality of life for patients with myeloma who do not necessarily need to be cured of their molecular disease, that is, they are 'operationally cured.' It is hoped that the reader will find the information in this issue useful in the day-to-day management of patients and we hope that this will also inspire new research directions designed to improve the outcome of patients with myeloma.