Current status of allogeneic transplantation for aggressive non-Hodgkin lymphoma

Abstract

Purpose To provide a succinct update on the role of allogeneic stem cell transplantation in the management of patients with aggressive lymphomas. To clarify the indications for allogeneic transplantation vis-à-vis autologous transplant and to discuss the rational and potential benefits of reduced intensity conditioning(RIC), non-myeloablative (NMA) transplant, T-cell depletion and variations in GVHD prophylaxis. Recent findings Considerable effort has been spent in developing transplant regimens with reduced toxicity and reduced GVHD. The role of allogeneic transplantation has also been redefined in light of advances in lymphoma classification, diagnostic methods, particularly PET scan and advances in transplant technology. Haplo and UCB SCT allow identification of a donor for nearly all patients. Summary RIC and NMA conditioning have reduced early toxicity but are associated with increased risk for disease recurrence. Promising data have been reported from a novel conditioning regimen combining NMAwith ibritumomab tiuxetan. T-cell depletion reduces cGVHD but has some increase in rate of recurrence. Rapamycin may be associated with reduction in risk for disease recurrence. In diffuse large B cell lymphoma, the outcome of allo SCT depends on patient characteristics and chemosensitivity. It is seful after failure of autoSCT and in partial responses to salvage therapy. Allo SCT may be the treatment of choice for advanced T-cell and NK cell lymphoma and for ATLL. Prophylactic or preemptive DLI may be useful, but requires controlled studies.

Donor Lymphocyte Infusion for Relapsed Hematological Malignancies after Unrelated Allogeneic Bone Marrow Transplantation Facilitated by the Japan Marrow Donor Program

“…Nevertheless, because mortality associated with a second allo-HSCT for relapsed recipients is considered to be much higher, DLI therapy may represent a viable alternative to second allo-HSCT. Thus, DLI has been applied in the treatment of various hematological malignancies [6][7][8], such as leukemias [9,10], lymphoma [11][12][13], and myeloma [14,15]. In particular, patients who have relapsed after unrelated allo-HSCT because of lack of HLA-matched related sibling donors may also benefit from unrelated DLI (UDLI) [16].…”

Effect of magnetic nanoparticles on apoptosis and cell cycle induced by wogonin in Raji cells

“…Unfortunately, a considerable number of patients undergoing cyclophosphamide, doxorubicin, vincristine, and prednisone relapse thereafter or suffer from dose-related side effects and complications. Furthermore, stem cell transplantation, as a treatment of curing NHL, 2 is too expensive for patients, so curative treatment can be achieved in only a minority of NHL patients. Thus, novel therapeutic strategies are urgently needed to improve palliative treatment, prolong life expectancy, and improve quality of life in patients with lymphoma.…”

Peripheral T-cell Lymphomas

“…CBV is another common preparative regimen for auto-HSCT and was reported as a safe and an effective RIC for allo-HSCT in patients with NHL. [ 29 ] Many studies reported that the TRM in the setting of RIC was range from 20% to 44%. [ 25 ]…”