IntroductionMultiple myeloma (MM) is an incurable B-cell malignancy characterized by the accumulation of neoplastic plasma cells mainly in the bone marrow. 1 High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) as well as molecular-targeting therapy for both MM cells and the bone marrow microenvironment have prolonged overall survival in patients with MM; however, most patients still ultimately have a relapse because of the emergence of residual disease. [2][3][4][5][6] Because cellular immunotherapy, including allogeneic transplantation and donor lymphocyte infusion, is the only approach to induce a cure, [7][8][9] immune-based strategies to eradicate the remaining MM cells have been studied extensively in recent years. 10 Active immunotherapy based on either immunization against tumor-specific antigens or dendritic-cell (DC) vaccines generated ex vivo represents an ideal approach for inducing tumor-specific immunity. 11 Specifically, immunoglobulin idiotype (Id) has been considered as the most specific tumor antigen, and clinical trials using Id-pulsed DC vaccinations have demonstrated cytotoxic T lymphocyte (CTL) responses in some patients with MM. [12][13][14] In addition, generation of MM-specific CTLs has been achieved by using DCs pulsed with MM-cell lysates. 15 Unfortunately, vaccination with Id variations or primary MM-cell lysates cannot provide shared immunotherapy for other MM patients and this problem may limit the wide clinical application of these methods. To date, several tumor-associated antigens such as MUC1, WT-1, Sp-17, NY-ESO-1, SPAN-Xb, and MAGE families have been shown to mediate immune responses against MM cells, 16-21 but these antigens are not consistently expressed on MM cells. 22 Therefore, it is necessary to identify relevant MM-specific antigens for developing more efficient strategies for large numbers of patients with MM.HM1.24 was originally identified as a cell-surface protein that is preferentially overexpressed on MM cells 23 and later was found to be identical to bone marrow stromal cell antigen 2 (BST-2). 24,25 HM1.24/BST-2 (CD317) is also expressed at low levels in selected tissues but is specifically up-regulated in metastatic tumor cells and chemoresistant cancer cells. 26,27 Subsequent studies have revealed that HM1.24 is a type II transmembrane glycoprotein with a unique topology that is present in lipid rafts via a glycosylphosphatidylinositol anchor at the C-terminus and that the rat homologue of cell-surface HM1.24 can be internalized and localized to the trans-Golgi network. 28 Moreover, large-scale analysis of the human cDNA has demonstrated that the HM1.24 gene is one of the important activators of the nuclear factor B pathway that is involved in the pathogenesis of MM. 29 These findings suggest that HM1.24 provides a platform for a signaling complex at the cell 32 Based on these findings, we hypothesized that the generation of HM1.24-specific CTLs might become an attractive strategy for residual disease after PBSCT.In ...