Chemotherapy, Vaccine Therapy, and Stem Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma

Inclusion Criteria

• •Initial Presentation
• •Age between 18 and 70 years
• •ECOG 0 - 2
• •Patients with histologically confirmed multiple myeloma with ≥ 30% bone
• •marrow involvement and a de novo presentation. One cycle of prior
• •chemotherapy for myeloma is allowed. Local radiation therapy is permitted
• •Ability to give informed consent
• •No existing secondary malignancies and no history of secondary malignancies in the past 5 years (other than a history of carcinoma in situ of the cervix, superficial skin cancer, or superficial bladder cancer)
• •No active autoimmune disease, nor a history of any autoimmune disease requiring medical treatment with systemic immunosuppressants
• •No corticosteroids within 28 days of tumor harvest
• •No major active medical or psychosocial problems that could be exacerbated or complicated by this treatment
• •Not pregnant
• •HIV negative
• •AST/ALT, total bilirubin \< threefold normal
• •Absolute neutrophil count \>500/mm3
• •Platelet count \>30,000/mm3
• •Prior to Transplantation
• •ECOG performance status of 0 - 2.
• •No active/uncontrolled infection.
• •Absolute neutrophil count (ANC) \>1000/mm3.
• •Platelet count \>50,000/mm3.
• •Hemoglobin \>8g/dL
• •AST/ALT, total bilirubin \<3-fold normal.
• •50% or greater reduction in tumor burden with prior chemotherapy
• •Patient has received a minimum of 2 cycles of an accepted induction
• •chemotherapy regimen
• •Patient fulfills the requirements for standard peripheral stem cell transplantation Prior to Posttransplant Vaccination
• •No active/uncontrolled infection
• •Absolute neutrophil count (ANC) \>1000/mm3
• •Platelet count \>50,000/mm3
• •Hemoglobin \>8g/dL
• •AST/ALT, total bilirubin \<3-fold normal
• •No unresolved Grade 3 or 4 adverse events related to the transplant