Although advanced stage aggressive non-Hodgkin's
lymphomas and
Hodgkin's disease are thought to be
chemotherapy-responsive
cancers, a considerable number of patients either relapse or never attain a remission. High-dose
therapy (HDT) followed by autologous
stem cell transplantation (ASCT) is often the only possibility of cure for most of these patients. However, many controversial issues still remain with respect to HDT/ASCT for
lymphomas, including its role for, the optimal timing of
transplantation, the best conditioning regimen and the potential use of localized
radiotherapy or immunologic methods to decrease post-transplant recurrence. Recently, mainly due to the unavailability of
carmustine, several novel conditioning protocols have been clinically developed, with the aim of improving the overall outcome by enhancing the anti-
lymphoma effect and, at the same time, by reducing short and long-term toxicity. Furthermore, the better safety profiles of novel approaches would definitively allow patients aged more than 65-70 years to benefit from this therapeutic option. In this review, we will briefly discuss the most relevant and recent data available regarding HDT/ASCT in
lymphomas.