Transplantation for non-Hodgkin lymphoma.

Abstract

High-dose therapy followed by autologous hematopoietic stem cell transplantation (auto-HCT) has become the treatment of choice for patients with relapsed aggressive non-Hodgkin lymphoma (NHL). However, relapse remains the most common cause of treatment failure after auto-HCT. More intensive regimens incorporating radioimmunotherapy into high-dose regimens have been developed to prevent relapse. The role of auto-HCT for follicular lymphoma and mantle cell lymphoma remain inconclusive. Since prognosis of patients with peripheral T-cell lymphoma, not otherwise specified are very poor with conventional chemotherapy, auto-HCT during first remission is being explored in peripheral T-cell lymphoma. Given the lower risk of relapse after allogeneic HCT (allo-HCT) in NHL, allo-HCT has been performed in patients with refractory or relapsed NHL, especially after auto-HCT failure. However, the transplant-related mortality remains high after myeloablative allo-HCT. Reduced-intensity conditioning followed by allo-HCT has been shown to reduce transplant-related mortality but graft-versus-host disease continues to be the major problem, thus the role of allo-HCT in NHL remains an investigational approach for NHL. The outcomes of auto-HCT and allo-HCT for various lymphomas are reviewed.

• Authors: Auayporn Nademanee
• Journal: Expert review of hematology (Expert Rev Hematol) Vol. 2 Issue 4 Pg. 425-42 (Aug 2009) ISSN: 1747-4094 [Electronic] England
• PMID: 21082947 (Publication Type: Journal Article, Review)

Topics

• Combined Modality Therapy
• Disease-Free Survival
• Hematopoietic Stem Cell Transplantation
• Humans
• Lymphoma, Non-Hodgkin (drug therapy, surgery, therapy)