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Prepublished online as a Blood First Edition Paper on April 30, 2002; DOI 10.1182/blood-2002-01-0131. This Article Full Text (PDF) All Versions of this Article: 2002-01-0131v1 100/3/755    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kroger, N. Articles by Zander, A. R Search for Related Content PubMed PubMed Citation Articles by Kroger, N. Articles by Zander, A. R Social Bookmarking                   What's this? Submitted January 17, 2002 Accepted February 20, 2002 Autologous stem cell transplantation followed by a dose-reduced allograft induces high complete remission rate in multiple myeloma Nicolaus Kroger*, Rainer Schwerdtfeger, Michael Kiehl, Herbert G Sayer, Helmut Renges, Tatjana Zabelina, Boris Fehse, Florian Togel, Georg Wittkowsky, Rolf Kuse, and Axel R Zander Bone Marrow Transplantation, University Hospital Hamburg, Hamburg, Germany Bone Marrow Transplantation, Deutsche Klinik fur Diagnostik, Wiesbaden, Germany Bone Marrow Transplantation, Idar-Oberstein, Idar-Oberstein, Germany University Jena, Department of Oncology and Hematology, Jena, Germany Department of Hematology/Oncology, A.K. St. Georg, Hamburg, Germany * Corresponding author; email: nkroeger{at}uke.uni-hamburg.de. We evaluated toxicity, engraftment, chimerism, graft-versus host disease (GvHD) and response to a dose-reduced allograft after cytoreductive autograft in 17 patients with advanced stage II/III multiple myeloma (MM). After autografting with melphalan (200 mg/m2) the patients received after a median interval of 119 days (range 60-210) a dose-reduced regimen consisting of fludarabine (180 mg/m2), melphalan (100 mg/m2) and anti-thymocyte globulin (3x10mg/kg) followed by allografting from related (n=7), mismatched related (n=2), or unrelated (n=8) donors to induce a graft versus myeloma effect. After dose-reduced allografting all patients became neutropenic ( < 0.2 x109/L) for at least 8 days. All patients engrafted with a median time for leukocytes (>1 x 109/L) and platelets (>20 x 109/L) count of 16 (range 11-24) and 23 days (range 12-43), respectively. Complete donor chimerism was detected after a median of 30 days (range 19 to 38). Acute GvHD II-IV occured in 4 patients (25%), grade III GvHD in two patients (13%). 40% developed chronic GvHD, but only one patient experienced extensive chronic GvHD requiring further immunosuppressive therapy. Two patients died of alveolar hemorrhage and of pneumonia, respectively, resulting in a day 100 mortality of 11%. The rate of complete remission (CR) with negative immunofixation increased from 18% after autografting to 73% after allografting. After a median follow-up of 17 months after autologous and 13 months after allogeneic transplantation 13 are alive and 12 of them free of relapse- or progression. The tandem auto-allo-transplant-protocol is highly active and provides rapid engraftment with complete donor chimerism and tolerable toxicity. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Rotta, B. E. Storer, F. Sahebi, J. A. Shizuru, B. Bruno, T. Lange, E. D. Agura, P. A. McSweeney, M. 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