five or six HLA antigen-matched sibling, or lack of means to 
undergo an allogeneic transplantation. 
4.5 Marrow cellularity of greater than 30%, with an average 
of < 30% plasma cells in bilateral pre-study bone marrow 
aspirates and biopsies. Patients with extensive marrow 
fibrosis will be excluded. Pre-study peripheral blood 
counts must include a platelet count of greater than 
100, 000/ul and an absolute neutrophil count of greater than 
1500/ul. 
4.6 Demonstration of a partial or complete response to 
initial or salvage therapy (a minimum of a 50 % reduction in 
the detectable serum paraprotein or at least a 90% reduction 
in the detectable urine monoclonal light chains, stable for 
at least four weeks prior to entry into study and initiation 
of cyclophosphamide for peripheral blood stem cell 
mobilization, off of therapy) . 
4.7 At time of entry into study FEV1/FVC > 75% of predicted, 
DLCO > 50 % of predicted, LVEF > 50%, bilirubin < 2.0, 
transaminases < 2X upper limit of normal, serum creatinine < 
2.0. Patient should have no other significant active 
medical problems, including coronary artery disease, serious 
infection, HIV positivity, uncontrolled diabetes mellitus, 
or any other illness that, in the opinion of the principle 
investigators, would jeopardize the ability of the patient 
to tolerate aggressive chemoradiotherapy or be aggravated by 
the treatment regimen. Patients with a prior history of 
another malignancy will be excluded, with the exception of 
localized basal cell or squamous skin carcinoma or localized 
bladder carcinoma. Other malignancies for which the patient 
did not receive prior chemotherapy and were cured by local 
surgery, such as head and neck carcinoma or stage I breast 
cancer, will be considered on an individual basis. 
4.8 Prior irradiation to > 10 cm 2 of lung tissue or greater 
than 2000 rads to the thoracic spine will exclude patients 
from total body irradiation.' Prior radiation therapy 
extensive enough to preclude TBI will not exclude the 
patient from this study unless it is also extensive enough 
to preclude adequate bone marrow harvest. Patients unable 
to receive TBI due to prior radiation therapy will receive 
higher-dose conditioning chemotherapy (see section 5.5). 
Patients with active lytic lesions or plasmacytomas 
requiring ongoing radiation therapy will be excluded from 
the trial until their radiation treatments are completed. 
All patients will be evaluated by the radiation therapy 
department prior to inclusion in the protocol. 
4.9 Marrow harvest of > 0.5 X 10 8 nucleated cells/kg body 
weight (preprocessing) will be required for the patient to 
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Recombinant DNA Research, Volume 16 
