Study of Ipilimumab After Stem Cell Transplantation in People With Relapsed/Refractory Multiple Myeloma

Inclusion Criteria

• •Willing and able to participate as a research subject and provide informed consent (Note: an LAR may sign the consent form on the partipant's behalf)
• •Diagnosis of relapsed refractory multiple myeloma defined as more than 2 lines of prior therapy with at least a very good partial remission to most recent salvage therapy.
• •* Patients should have R-ISS stage II or III disease at diagnosis or high risk cytogenetics by IMWG criteria (t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperdiploidy, and gain(1q)) at any time since diagnosis
• •Note:. A line of therapy is treatment between diagnosis and progression or between two progressions
• •Eligible for CD34-selected HSCT according to MSKCC adult BMT guidelines.
• •Have a 10/10 matched donor
• •Age ≥ 21, \< 73 years.
• •Karnofsky (adult) Performance Status ≥ 70%.
• •Patients must have adequate organ function measured by:
• •1. Cardiac: LVEF at rest must be ≥ 50%
• •2. Hepatic:
• •* \< 3x ULN ALT
• •* \< 1.5 ULN total serum bilirubin, unless there is congenital benign hyperbilirubinemia.
• •3. Renal: serum creatinine \<1.2 mg/dl or if serum creatinine is outside the normal range, then CrCl \> 40 ml/min (measured or calculated/estimated) with dose adjustment of Fludarabine for \<70ml/min
• •4. Pulmonary: DLCO \> 50% of predicted (corrected for hemoglobin).
• •Non progressive myeloma (partial response or better) as defined by International Myeloma Working Group (IMWG) criteria
• •Engraftment of all cell lines without transfusion dependence, defined as:
• •* absolute neutrophil count \> 1.0K/mcL x 3 consecutive days
• •* platelets \> 50K/mcLx 7 consecutive days without platelet transfusion
• •* no platelet or RBC transfusions within the preceding 7 days
• •≥ 80% donor chimerism in the bone marrow