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Stem Cell Transplantation for Non-Hodgkin’s Lymphomas

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Lymphoma

Part of the book series: Current Clinical Oncology ((CCO,volume 43))

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Abstract

Both autologous and allogeneic transplants have been extensively studied in the management of non-Hodgkin’s lymphomas and may offer a chance of a long-term cure for some patients. Autologous stem cell transplantation is considered standard therapy for patients with diffuse large B cell lymphoma in chemotherapy-sensitive relapse. It is also widely applied for patients with T cell histologies both as consolidation of first remission and in the salvage setting. It is also often used in patients with other histologic subtypes like follicular lymphoma, primary central nervous system lymphoma, and mantle cell lymphoma. Allogeneic stem cell transplantation also confers an immune-mediated graft-versus-lymphoma effect which can produce long-term remissions in selected patients in settings where autologous transplants may not be effective. However, when compared to autologous transplants, allogeneic transplants are associated with higher complication rates and higher transplant-related mortality rates. This is primarily due to the toxicity of the high-dose regimen, acute and chronic graft-versus-host disease, and the associated risk of infections. Therefore, allogeneic transplants have ­historically been restricted to patients who are young and have a good performance status. There is recent interest in non-myeloablative or reduced-intensity conditioning regimen allogeneic transplants as a means of exploiting the graft-versus-lymphoma effect with less toxicity and lower regimen-related mortality. Several trials in lymphoma have been published evaluating the role of high-dose therapy and comparing the outcomes of allogeneic or autologous hematopoietic stem cell transplantation. In this chapter, we review the use of autologous and allogeneic transplants for the common subtypes of non-Hodgkin’s lymphoma.

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  1. Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Chitra Hosing MD & Richard E. Champlin MD

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    Bertrand Coiffier

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Hosing, C., Champlin, R.E. (2013). Stem Cell Transplantation for Non-Hodgkin’s Lymphomas. In: Younes, A., Coiffier, B. (eds) Lymphoma. Current Clinical Oncology, vol 43. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-408-1_23

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