Management of patients with multiple myeloma having dialysis-dependent renal failure, particularly if the disease is refractory to several lines of therapy, is a difficult task. Cure of such patients represents a real challenge to the treating team. In late November 2009, the diagnosis of multiple myeloma was made in a young patient who had been receiving regular hemodialysis for end-stage renal disease. His myeloma was refractory to four lines of therapy and it responded partially to the fifth line of treatment. Thereafter, the patient received a noncryopreserved autologous hematopoietic stem cell transplantation which brought his myeloma under more optimal control. One year later, he received live-related kidney transplantation. During his subsequent follow-up for fifty four months post-renal transplantation at King Fahad Specialist Hospital in Dammam, Saudi Arabia, no complication has been encountered. As the case is complicated, the literature review will be detailed in order to discuss the various aspects related to care of the patient presented.
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