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

Inclusion Criteria:

Patients meeting criteria for symptomatic myeloma
Patients who have progressive myeloma following initial induction (patients may have received any number of treatment regimens including prior autologous transplant)
Patient age 18-75 years at time of enrollment
Karnofsky performance status of ≥70
Cardiac function: LVEF >40%
Hepatic: Bilirubin <2x upper limit of normal and ALT and AST < 2.5x the upper limit of normal
Renal: Creatinine clearance of >30mL/min, estimated or calculated
Pulmonary: DLCO, FEV1, FVC >50% of predicted (after correction for hemoglobin)

Exclusion Criteria:

Patients with diagnosis of plasma cell leukemia
Patients with truly non secretory myeloma (patients with light chain disease are eligible)
Pregnant or breast-feeding
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.
Patients who have undergone prior allogeneic stem cell transplant
Prior solid organ transplant
Patients receiving prior radiation to more than 20% of bone marrow containing areas