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Seventeen multiple myeloma (2, S.IIA, 1, S.IIB; and 14, S.IIIA) and 1 loco-regional advanced extramedullary myeloma patients were treated with ICOMP chemotherapy (Idarubicin, I 10mg/m2day 1; Cyclophosphamide, CTX 1.2g/m2days 1 and 3; Vincristine, O 1.2mg/m2day 1 and methylprednisolone, MP 250mg days I and 3, 125mg days 2 and 4). All drugs were given IV. G-CSF (5 J.μg/kg) was administered SC from day 5 to recovery from neutropenia. All patients, but one, had received prior chemotherapy (median 3 types combmations, range 1–7). Nine had relapsing and 9 resistant disease to previous treatment. Five patients discontinued therapy, 1 after the 1stcycle because of herpes zoster, 3 because of disease progression (l after the 2nd, 1 after the 3rdand 1 after the 5thcycle). The last developed a non-therapy related myocardial infarction 5 days after the 3rdcycle. Nine PR, 4 SD and 1 PD were observed in the 13 patients who completed at least 6 cycles. In the first 6 cycles, 18/18, 16/17, 14/16, 12/14, 12/14 and 11/13 patients respectively received between 75% and 100% of the planned I dose and 18/18, 16/17, 14/16, 14/14, 13/14 and 12/13 patients 75%–100% of the projected CTX dose. A WBC <1000/cmm was documented in 10/18 (median 3.5 days, range 2–11), 9/17 (4, 2–15), 8/16 (3, 2– 6), 7/14 (3, 1–5), 7(14 (3, 1–5) and 5/13 (3, 2–6) from the 1st to the 6th cycle and a platelet count < 100,000/cmm in 7/18 (9, 5–28), 9/17 (8, 1–31),7/16 (10, 3–28), 7/l4 (6, 2–28), 8/14 (7, 2–34), 5/13 (2, 1–20). Our results indicate that the therapeutic regimen adopted is reasonably well tolerated as well as active against advanced MM.