The frequency of clonotypic B cells is slightly reduced by conventional chemotherapy in most patients, and is maintained after autologous transplantation (auto-tnsp), but clonotypic B cells are depleted after cytoreduction therapy and allogeneic transplantion. (A) The number of circulating clonotypic B cells was monitored at the time points after diagnosis as indicated. Data points are from Table 3. Patient ID numbers are given in the figure. For patients 1, 2, 7, 15, and 18 chemotherapy was initiated immediately after diagnosis and continued at monthly intervals until month 7. With the exception of the 10- and 13-month time points, patients 3, 5, and 6 were on chemotherapy for the time points recorded here. Patient 11 remained untreated for both samples shown here. (B) This patient was analyzed for clonotypic B cells a few days before stem-cell mobilization with G-CSF (mIg = 16 gm/L and 11% plasma cells in BM, a 75% decrement in response to treatment). The frequency of clonotypic B cells was analyzed in the G-CSF–mobilized blood cells, and in a blood sample taken at 1 month after cytoreduction and autologous transplantation, at which time the patient had a further 20% reduction in mIg for a total decrement of 95%. This patient has since remained in partial remission. (C) This patient was treated with VAD for 6 cycles followed by high-dose cytoxan and radiation, followed by allogeneic hematopoietic transplantation (Allo Tsnp) and immunosuppression with cyclosporin A. This patient remains in complete remission.