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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 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 Citation Map 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 Kröger, N. Articles by Zander, A. R. Search for Related Content PubMed PubMed Citation Articles by Kröger, N. Articles by Zander, A. R. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 August 2002, Vol. 100, No. 3, pp. 755-760 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Autologous stem cell transplantation followed by a dose-reduced allograft induces high complete remission rate in multiple myeloma Nicolaus Kröger, Rainer Schwerdtfeger, Michael Kiehl, Herbert Gottfried Sayer, Helmut Renges, Tatjana Zabelina, Boris Fehse, Florian Tögel, Georg Wittkowsky, Rolf Kuse, and Axel Rolf Zander From the Bone Marrow Transplantation, University Hospital Hamburg, Department of Bone Marrow Transplantation, Wiesbaden and Idar-Oberstein, Department of Oncology and Hematology University Jena, and Department of Hematology AK St Georg, Hamburg, Germany. We evaluated toxicity, engraftment, chimerism, graft-versus-host disease (GVHD), and response to a dose-reduced allograft after cytoreductive autografting 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 antithymocyte globulin (3 × 10 mg/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 × 109/L) for at least 8 days. All patients engrafted with a median time for leukocyte (> 1 × 109/L) and platelet (> 20 × 109/L) counts of 16 (range, 11-24) and 23 days (range, 12-43), respectively. Complete donor chimerism was detected after a median of 30 days (range, 19-38). Acute GVHD stage II occurred in 4 patients (25%) and grade III GVHD in 2 patients (13%). Chronic GVHD developed in 40% of the patients, but only 1 patient experienced extensive chronic GVHD requiring further immunosuppressive therapy. Two patients died of alveolar hemorrhage and pneumonia, resulting in a day 100 mortality rate of 11%. The rate of complete remission 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 patients are alive and 12 of them free of relapse or progression. The tandem auto-allotransplant protocol is highly active and provides rapid engraftment with complete donor chimerism and tolerable toxicity. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. Atanackovic, Y. Cao, T. Luetkens, J. 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