Early Response-adapted Intensification of Induction Chemotherapy in Patients With Newly Diagnosed Multiple Myeloma (MM)

Inclusion Criteria:

1. Newly diagnosed MM
2. Aged between 18 and 65 years old
3. With following measurable lesions (serum M-protein ≥ 1 g/dL or urine M-protein ≥ 400 mg/day, or free light chain ≥ 100 mg/L)

Exclusion Criteria:

1. Smoldering or indolent myeloma
2. ECOG performance status \> 3 point
3. Known hypersensitivity to cyclophosphamide, thalidomide or dexamethasone
4. Peripheral neuropathy or neuropathic pain Grade 2 or higher as defined by NCI CTCAE version 3
5. Uncontrolled or severe cardiovascular disease, including MI within 6 months of enrolment, NYHA Class III or IV heart failure, uncontrolled angina, clinically significant pericardial disease, or cardiac amyloidosis, cardiac ejection fraction \<0.5 : Severe conduction disorder : Hypotension (sitting systolic BP ≤ 100 mmHg and/or sitting diastolic BP ≤ 60 mmHg
6. Impaired hepatic function (AST or ALT ≥ x 3 upper normal, T-bilirubin ≥ x 2 upper normal)
7. Creatinine clearance \< 20 ml/min
8. Corrected serum calcium ≥ 14 mg/dL
9. Sepsis or current active infection
10. Pregnancy or breast feeding
11. Uncontrolled Diabetes Mellitus
12. Previous history of Recurrent DVT or pulmonary embolism
13. Active ulcers detected by gastroscopy
14. Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
15. Receipt of extensive radiation therapy within 4 weeks