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AUTHORS: N. Kröger1, F. Ayuk1, D. Atanackovic2, A. Zander1
1 Dept. of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Germany
2 Dept. of Oncology and Hematology, University Hospital Hamburg-Eppendorf, Germany
by Lynne Lederman, PhD
Dr. Kroger called allogeneic SCT the most harmful treatment and the one most likely to eliminate myeloma or lead to long term freedom from disease. DLI can promote GVHD or lead to graft vs. tumor effects. GVHD has been associated with response. Until recently, DLI has been used mostly after relapse, but has been studied as post-transplant maintenance therapy. Because DLI can’t reach extramedullary disease, it is not appropriate as monotherapy. It may be possible to vaccinate the donor prior to transplant to create myeloma specific, anti-idiotype T cells, or to induce cells specific to other myeloma-associated antigens, e.g., to cancer testis antigen or to MUC-1. Dr. Kroger believes that molecular remission is more important than CR. In a small study, patient-specific markers were monitored by polymerase chain reaction (PCR), and shown to be associated with 5-year risk of relapse.