Inclusion Criteria:

          -  Patients must have newly diagnosed active Multiple Myeloma (MM) requiring treatment.
             Patients with a previous history of smoldering myeloma will be eligible if there is
             evidence of progressive disease requiring chemotherapy.

          -  Patients must be either untreated or have not received more than four cycles of
             systemic MM therapy (e.g. Revlimid Dexamethasone (RD), Bortezomib Revlimid
             Dexamethasone (VRD). Prior bisphosphonates and localized radiation are allowed.

          -  Participants must have high-risk disease, as defined by at least one of the following:

          -  Myeloma Prognostic Risk Signature (MyPRS) risk score ≥ 50.4

          -  Lactate Dehydrogenase (LDH) ≥ 360 U/L (Rule out hemolysis and infection; contact PI if
             any doubt.)

          -  Diagnosis of primary plasma cell leukemia.

          -  Eastern Cooperative Oncology Group (ECOG) ≤ 2, unless solely due to symptoms of
             MM-related bone disease.

          -  Patients must have a platelet count ≥ 50,000/μL, unless lower levels are explained by
             extensive bone marrow plasmacytosis.

          -  Patients must be at least 18 years of age and not older than 75 years of age at the
             time of registration.

          -  Participants must have a baseline serum creatinine level < 3 mg/dL and baseline
             Alanine Aminotransferase (ALT) < 3x Upper Limit of Normal (ULN).

          -  Participants must have an ejection fraction by echocardiogram (ECHO) or Multiple-gated
             Acquisition Scan (MUGA) scan ≥ 45%

          -  Patients must have adequate pulmonary function studies > 50% of predicted on
             mechanical aspects (Forced Expiratory Volume 1 (FEV1), Forced Vital Capacity (FVC) and
             diffusion capacity (DLCO) > 50% of predicted. If the patient is unable to complete
             pulmonary function tests due to MM related pain or other conditions, an exception may
             be granted if the principal investigator documents that the patient is a candidate for
             high dose therapy.

          -  Patients must have signed an Institutional Review Board (IRB)-approved informed
             consent indicating their understanding of the proposed treatment and that the protocol
             has been approved by the Institutional Review Board (IRB).

        Exclusion Criteria:

          -  No evidence of high-risk disease

          -  Poorly controlled hypertension, diabetes mellitus, active or uncontrolled hepatitis,
             or other serious medical or psychiatric illness that could potentially interfere with
             the completion of treatment according to this protocol.

          -  Patients must not have prior malignancy, except for adequately treated basal cell or
             squamous cell skin cancer, in situ cervical cancer, or other cancer for which the
             patient has not received treatment for one year prior to enrollment. Other cancers
             will only be acceptable if the patient's life expectancy exceeds five years.

          -  Pregnant or nursing women may not participate. Women of childbearing potential must
             have a negative pregnancy documented within one week of registration.

          -  Subjects of reproductive potential may not participate unless they have agreed to use
             an effective contraceptive method.