Reduced-intensity allogeneic transplantation for lymphoma

Curr Opin Oncol. 2002 Sep;14(5):475-83. doi: 10.1097/00001622-200209000-00002.

Abstract

Reduced-intensity allogeneic transplants are promising, increasingly used treatments for hematologic malignancies, exploiting graft-versus-tumor effects for eradicating malignancies. This article reviews approximately 40 published reports of reduced-intensity allogeneic transplants in lymphomas. Overall, reduced-intensity allogeneic transplants have been well tolerated and have produced encouraging results despite a diversity of transplant approaches used largely in heavily pretreated and older patients. Of 368 lymphoma patients who underwent reduced-intensity allogeneic transplants, 66.3% had responses, most of which were complete. Many had chemotherapy-refractory lymphomas, including some that relapsed after autologous transplants. Although the short follow-up periods of many studies do not permit assessments of response duration, protracted remissions were reported in some studies. Additionally, some patients entered molecular remissions, suggesting that graft-versus-tumor effects could, by themselves, cure some lymphomas. Graft-versus-host disease is the major risk of reduced-intensity allogeneic transplants, and treatment methods need refinement to reduce transplant risks while preserving graft-versus-tumor effects. Controlled trials involving patients with earlier-stage disease appear warranted to define better the role of reduced-intensity allogeneic transplants in treating lymphomas.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Dose-Response Relationship, Drug
  • Graft vs Host Disease
  • Graft vs Tumor Effect*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lymphoma / therapy*
  • Peripheral Blood Stem Cell Transplantation*
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Immunosuppressive Agents