A Review of Autologous Stem Cell Transplantation in Lymphoma

Curr Hematol Malig Rep. 2017 Jun;12(3):217-226. doi: 10.1007/s11899-017-0382-1.

Abstract

Purpose of review: Chemotherapy remains the first-line therapy for aggressive lymphomas. However, 20-30% of patients with non-Hodgkin lymphoma (NHL) and 15% with Hodgkin lymphoma (HL) recur after initial therapy. We want to explore the role of high-dose chemotherapy (HDT) and autologous stem cell transplant (ASCT) for these patients.

Recent findings: There is some utility of upfront consolidation for-high risk/high-grade B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma, but there is no role of similar intervention for HL. New conditioning regimens are being investigated which have demonstrated an improved safety profile without compromising the myeloablative efficiency for relapsed or refractory HL. Salvage chemotherapy followed by HDT and rescue autologous stem cell transplant remains the standard of care for relapsed/refractory lymphoma. The role of novel agents to improve disease-related parameters remains to be elucidated in frontline induction, disease salvage, and high-dose consolidation or in the maintenance setting.

Keywords: Autologous stem cell transplantation; High-dose chemotherapy; Lymphoma; Novel agents; Relapsed/refractory; Salvage chemotherapy.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Consolidation Chemotherapy
  • Drug Resistance, Neoplasm
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Lymphoma / diagnosis
  • Lymphoma / etiology
  • Lymphoma / mortality
  • Lymphoma / therapy*
  • Molecular Targeted Therapy
  • Recurrence
  • Retreatment
  • Salvage Therapy
  • Transplantation Conditioning / methods
  • Transplantation, Autologous
  • Treatment Outcome