title: Post-transplant immunotherapy with donor-lymphocyte infusion and novel agents to upgrade partial into complete and molecular remission in allografted patients with multiple myeloma.
abstract: OBJECTIVE
  To investigate post-transplant immunotherapy with escalating donor-lymphocyte infusions (DLI) and novel agents (thalidomide, bortezomib, and lenalidomide) to target complete remission (CR).
  
  
  METHODS
  Thirty-two patients with multiple myeloma who achieved only partial remission after allogeneic stem cell transplantation were treated with DLI. If no CR was achieved, one of the novel agents was added to target CR.
  
  
  RESULTS
  CR defined either by European Group for Blood and Marrow Transplantation criteria, flow cytometry, or molecular methods as assessed by patient-specific immunoglobulin H-polymerase chain reaction or plasma cell chimerism polymerase chain reaction was accomplished in 59%, 63%, and 50% of patients, respectively. Achievement of CR resulted in improved 5-year progressive-free and overall survival, according to European Group for Blood and Marrow Transplantation criteria (53% vs 35%; p=0.03 and 90% vs 62%; p=0.06), flow cytometry (74% vs 15%; p=0.001 and 100% vs 52%; p=0.1), or molecular methods (84% vs 38%; p=0.001 and 100% vs 71%; p=0.03).
  
  
  CONCLUSIONS
  Our finding demonstrates the clinical relevance of posttransplantation therapies to upgrade remission, and of remission's depth for long-term survival in myeloma patients.
authors.affiliation: Department for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. nkroeger@uke.uni-hamburg.de
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Anita
authors.initials: A
authors.lastname: Badbaran
authors.forename: Michael
authors.initials: M
authors.lastname: Lioznov
authors.forename: Sabine
authors.initials: S
authors.lastname: Schwarz
authors.forename: Silke
authors.initials: S
authors.lastname: Zeschke
authors.forename: York
authors.initials: Y
authors.lastname: Hildebrand
authors.forename: Francis
authors.initials: F
authors.lastname: Ayuk
authors.forename: Djordje
authors.initials: D
authors.lastname: Atanackovic
authors.forename: Georgia
authors.initials: G
authors.lastname: Schilling
authors.forename: Tatjana
authors.initials: T
authors.lastname: Zabelina
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bacher
authors.forename: Evgeny
authors.initials: E
authors.lastname: Klyuchnikov
authors.forename: Avichai
authors.initials: A
authors.lastname: Shimoni
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Boris
authors.initials: B
authors.lastname: Fehse
authors.forename: Axel
authors.initials: A
authors.lastname: Zander
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017690:Cell Transplantation; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007167:Immunotherapy; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents