{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:40:10Z","timestamp":1789699210942,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T00:00:00Z","timestamp":1343001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Patients with multiple myeloma (<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>) undergoing high dose therapy and autologous stem cell transplantation (<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>) remain at risk for disease progression. Induction of the expression of highly immunogenic cancer testis antigens (<jats:styled-content style=\"fixed-case\">CTA<\/jats:styled-content>) in malignant plasma cells in <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> patients may trigger a protective immune response following <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. We initiated a phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> clinical trial of the <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> hypomethylating agent, azacitidine (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>za) administered sequentially with lenalidomide (Rev) in patients with <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>. Three cycles of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>za and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ev were administered and autologous lymphocytes were collected following the 2nd and 3rd cycles of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>za\u2010<jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ev and cryopreserved. Subsequent stem cell mobilization was followed by high\u2010dose melphalan and <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. Autologous lymphocyte infusion (<jats:styled-content style=\"fixed-case\">ALI<\/jats:styled-content>) was performed in the second month following transplantation. Fourteen patients have completed the investigational therapy; autologous lymphocytes were collected from all of the patients. Thirteen patients have successfully completed <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> and 11 have undergone <jats:styled-content style=\"fixed-case\">ALI<\/jats:styled-content>. Six patients tested have demonstrated <jats:styled-content style=\"fixed-case\">CTA<\/jats:styled-content> up\u2010regulation in either unfractionated bone marrow (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) or <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>138+ cells (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). <jats:styled-content style=\"fixed-case\">CTA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CTAG<\/jats:styled-content>1<jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>)\u2010specific T cell response has been observed in all three patients tested and persists following <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. Epigenetic induction of an adaptive immune response to cancer testis antigens is safe and feasible in <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> patients undergoing <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2012.09225.x","type":"journal-article","created":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T08:48:15Z","timestamp":1343033295000},"page":"700-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Epigenetic induction of adaptive immune response in multiple myeloma: sequential azacitidine and lenalidomide generate cancer testis antigen\u2010specific cellular immunity"],"prefix":"10.1111","volume":"158","author":[{"given":"Amir A.","family":"Toor","sequence":"first","affiliation":[{"name":"Bone Marrow Transplant Program Department of Internal Medicine Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle K.","family":"Payne","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold M.","family":"Chung","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Program Department of Internal Medicine Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy T.","family":"Sabo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison F.","family":"Hazlett","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Program Department of Internal Medicine Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Kmieciak","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Sanford","sequence":"additional","affiliation":[{"name":"Department of Pathology Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Pathology Massey Cancer Center Virginia Commonwealth University Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"Clark","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Program Department of Internal Medicine Massey Cancer Center 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