Vaccine Therapy for Multiple Myeloma Utilizing Idiotype-Pulsed Allogeneic Dendritic Cells

To evaluate feasibility and safety of vaccination with allogeneic idiotype-pulsed dendritic cells following mixed chimeric allogeneic transplantation for multiple myeloma.

Inclusion criteria

1. For specimen collection and idiotype protein development:

• Must be secretory myeloma with at least .5g/dl serum IgG protein
• Clinically stage 2 or 3 multiple myeloma
• Karnofsky performance status of 70 or greater

• For Vaccination:
• Eligible patients must have completed tandem autologous and nonmyeloablative allogeneic transplant for multiple myeloma at Stanford University Medical Center with stable disease or complete response to prevaccine therapy
• Karnofsky performance status of 70 or greater.
• ALT and AST must be <2X upper limit of normal. Total bilirubin < 1.5X upper limit of normal.
• Serum creatinine <1.5X upper limit of normal.
• Hemoglobin >9g/dl
• Patients must be HIV negative.
• Patients must provide signed, informed consent

Donor Inclusion Criteria (allo donor is the same donor used for non-myeloablative transplant)

• Age >17 years
• HIV negative
• Must provide signed, informed consent Exclusion Criteria:1. For specimen collection and idiotype protein development:
• Patients with non-secretory myeloma
• Severe psychological or medical illness
• Pregnant or lactating women
• Subjects with > Grade I toxicity by NCI-CTC v 3.0
• Subjects with prognosis < 6 months

• For Vaccination:
• < 75 mg of idiotype protein purified from the patients serum
• < 25 million allogeneic idiotype-pulsed dendritic cells produced for vaccination
• Evidence of grade II-IV acute GVHD (defined in section 5E)
• Patients with evidence of myeloma disease progression as (defined below)
• Severe psychological or medical illness or concomitant medications which may interfere with the study as determined by the clinical investigator
• Patients on any other investigational agents
• Pregnant or lactating women
• Patients on any therapy for multiple myeloma or any chemotherapy drug, or immunomodulatory agent for treatment of multiple myeloma (e.g. thalidomide)
• Any patient on more than two of the following immunosuppressive agents or at a dose greater than that indicated for a single immunosuppressive agent:

• Mycophenolate Mofetil (MMF)- no greater than 1000mg twice a day
• Prednisone- no greater than .5mg/kg/day
• Cyclosporine- no greater than 300mg/day
• Tacrolimus (FK506)- no greater than 4mg/day