Of 305 consecutive patients with symptomatic multiple myeloma treated between 1965 and 1974, a total of 4% survived ten years. Virtually all were less than 65 years old, presented with low or intermediate stage disease, and responded well to chemotherapy. Prolonged unmaintained remissions, slow tumor growth, and recontrol of relapsing disease were common. Acute leukemia caused the death of two of six long-term survivors. Patients treated since 1974 lived longer than those seen previously, a finding attributed to better control of complications and more effective combination chemotherapy.