Dr. Ringden for the CIBMTR reported on outcomes for 177 recipients of matched sibling allogeneic SCT conditioned with a nonmyeloablative or reduced intensity conditioning (RIC) regimen for myeloma. The median age of patients was 50 (range 24-69) and 105 patients received a planned tandem autologous transplant followed by allogeneic SCT. With a median follow-up of 55 months (range 3-98) for all patients, and 25 months (range 3-76) for recipients of tandem autologous/allogeneic SCT, 3 year overall survival was quite reasonable at 45% (95% CI 33-58) for recipients of a single allogeneic SCT and 64% (53-75) for recipients of tandem autologous/allogeneic SCT. Treatment related mortality (TRM) at 3 years was 27 (17-38)% and 16 (10-25)% respectively and relapse rates were 48 (36-60)% and 41 (29-54)%. The 3 year progression free survival (PFS) was 25 (15-37)% and 42 (20-43)% demonstrating that long-term control was possible in some patients. The multivariate analysis showed that chronic GVHD decreased the probability of relapse (RR 0.43, P 5 0.012), though this effect was limited to patients without IgG myeloma for reasons that are difficult to explain. In addition, PFS was better with autologous 1 allogeneic HSCT compared to allogeneic SCT (RR 3.6, P 5 0.001), suggesting that dose intensive chemotherapy still has a major role in care of these patients. This report has many limitations. In particular it is a retrospective study and it is not known how patients were selected for specific therapies. Some findings are not easily explained, such as a benefit of chronic GVHD in terms of relapse noted only in patients without IgG myeloma. Nevertheless, it is a large study using available registry data demonstrating that at least in some patients, a GVM effect can be generated and long-term disease control achieved. Defining the proper patient population, timing of transplant, and the role for autologous/allogeneic SCT before RIC allogeneic SCT remain important subjects for future studies that hopefully will someday harness the GVM effect for maximal benefit.