Allogeneic transplantation for multiple myeloma

In multiple myeloma (MM), the standard of treatment for patients < 65 years is high-dose chemotherapy followed by autologous stem cell transplantation. However, following either a single or a tandem autograft MM invariably recurs due to the persistence of tumor cells either in the host and/or in the graft. Purification procedures have generally proved unsuccessful. Allogeneic transplantation not only skips graft tumor contamination, but also exerts an immune effect against the myeloma clone. This effect is also displayed by donor lymphocytes when infused to the recipient in adeguate amounts. Despite these biological advantages, the precinse role of allograft in MM remains controversial.