In an attempt to overcome this limitation, many groups have employed a tandem autologous, non-myeloablative allogeneic transplant with the aim of providing major cytoreduction, but an opportunity for the patient to recover from high-dose chemotherapy before the Allo-SCT. 14, 16, 26 In multivariable analysis, patients receiving a tandem autologous, non-myeloablative allogeneic transplant had reduced non-relapse mortality, but did not independently affect other outcomes. This analysis also indicated that relapse after a prior autologous transplant is associated with inferior survival as well as other outcome measures. As seen in prior studies, a b-2 microglobulin 44 was also independently associated with increased risk of progression or relapse as well as inferior survival. Female donors were associated with a significantly reduced risk of relapse or progression, consistent with other analyses that have shown more of a graft-vs disease effect from female to male transplants.