Dose-Reduced Allogeneic Stem Cell Transplantation After Autologous High-Dose Chemotherapy in Patients With Multiple Myeloma
Dose-Reduced Allogeneic Stem Cell Transplantation After Autologous High-Dose Chemotherapy in Patients With Multiple Myeloma
To evaluate the feasibility and efficacy of a autologous stem cell transplantation followed
 by a Melphalan/ Fludarabine based dose-reduced allograft from HLA-identical and
 HLA-compatible unrelated donor in patients with Multiple Myeloma. In those with non complete
 remission DLI and/ or new agents such as Bortezomib, Thalidomid or Lenalidomide can be used
 to upgrade remission.
Inclusion Criteria:

 -  Multiple Myeloma Stadium II / III acc. to Salmon and Durie

 -  signed informed consent

 -  adequate organ function prior autologous respectively allogeneic SCT

 -  availability of HLA-identical related or unrelated donor

 -  availability of at least 2 x 10^6 CD34+ cells per kg BW of recipient for the
 autologous SCT and at least 3 x 10^6 CD34+ cells for allogeneic SCT

 -  for MRD-SCT: 18-66 years; for MUD-SCT: 18-55 years

 -  at age <55 years existence of risk factors that make an myeloablative allogeneic
 transplantation to risky

 -  consent of donor to give DLI

 Exclusion Criteria:

 -  severe heart insufficiency

 -  cardiovascular diseases or severe concomitant diseases

 -  active infections that need antibiotic therapy

 -  positive for HIV or hepatitis

 -  malign secondary disease

 -  limited liver function with total bilirubin > 1.5 ULN

 -  increased transaminase > 3 ULN

 -  increased serum creatinine > 2 mg/dl

 -  pregnant or lactating women

 -  known hypersensitivity to Fludarabine or Melphalan

 -  participation in another trial