Emerging data suggest that achieving CR or near CR (nCR) will result in more durable remission and longer survival. Recent analysis of long term outcomes of patients treated on randomized French study IMG90 clearly indicates that the longest survivors are those patients who achieve at least very good partial response or complete response (Harousseau, 2003). At 7 years, 60% of patients were alive in a group, which achieved CR or near CR. In contrast, in a group of patients who achieved > PR but less than CR or near CR only 30% were alive and among patients who had less than PR none were alive. Similar results have bee recently reported for patients who underwent allogeneic stem cell transplant (Corradini et al., 2003). It is not clear whether CR in response to initial therapy and prior to transplant may have similar impact on overall outcomes. Regardless of specific transplant approach, survival curves do not plateau and all patients are expected to relapse, regardless of method of intensification therapy, possibly due to persistence of residual population of chemotherapy-resistant clonogenic myeloma cells.