In many clinical settings, what may appear to be small or trivial changes in schedule may have unexpected effects on clinical outcome, including substantially increased rates of Toxicity. The doses and schedules of the standard agents were fixed, with the goal to find an optimal dose of gemcitabine. Toxicity was defined as any regimen-related grade 4 or 5 adverse event, occurring within 30 days post transplant, that affected a vital organ, excluding adverse events that occur routinely in allosct. Toxicity was defined as severe gastrointestinal Toxicity or diarrhea, graft failure, or regimen-related death. Efficacy in Multiple myeloma is defined to have the following three requirements, based on urine and serum analyzed by immunofixation electrophoresis.