High-Dose Therapy in Lymphomas: A Review of the Current Status of Allogeneic and Autologous Stem Cell Transplantation in Hodgkin's Disease and Non-Hodgkin's Lymphoma

Abstract

Autologous stem cell transplantation has proven to be beneficial in selected patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). In patients with HD, transplantation appears to increase event-free survival in patients who fail to enter complete remission with initial therapy. When a patient relapses after a complete remission, transplantation is probably the best option and particularly so if the remission lasted less than 1 year. Transplantation as part of primary therapy for very highrisk patients may be beneficial, but is not standard therapy at this time. For patients with diffuse large-cell NHL, transplantation can be considered standard therapy for relapsed patients if they have chemotherapy-sensitive disease. The use of transplantation for high-risk patients in complete remission is promising, but definite recommendations cannot be made at this time. For follicular lymphomas, selected patients seem to benefit and studies are ongoing. Finally, the use of allogeneic stem cell transplantation can be useful in a select group of younger patients.

Prognostic Factors in Non-Hodgkin's Lymphoma Patients Treated by Autologous Stem Cell Transplantation: A Single Center Experience

“…In addition, due to differences in the selection criteria, transplant regimens and follow up, the comparison of studies is sometimes difficult (1). Numerous factors have been identified as significant in predicting patients' responses to transplantation, with the most useful of these being the sensitivity of the lymphoma to chemotherapy (3).…”

Correlations between hematopoietic progenitor cell counts as measured by Sysmex and CD34+ cell harvest yields following mobilization with different regimens

“…Patients with multiple myeloma, high-risk and relapsed non-Hodgkin's lymphoma (NHL), and high-risk or relapsed testicular cancer might benefit from high-dose chemotherapy (Attal et al 1996;Mink and Armitage 2001;Beyer et al 2001). Moreover, the transplantation of granulocyte colony-stimulating factor (G-CSF)-mobilized allogeneic peripheral blood progenitor cells (PBPCs) is increasingly used as the treatment of choice for defined hematological malignancies (Bensinger et al 2001).…”

Involved Field Radiation After Autologous Stem Cell Transplant for Diffuse Large B-Cell Lymphoma in the Rituximab Era

“…With combination chemotherapy like cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP) (2), about 50% of patients achieve long-term survival (3). Despite the success of initial chemotherapy, a significant percentage of patients will manifest primary refractory disease or relapse after achieving a complete response (CR).…”