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Current Controversies in Bone Marrow Transplantation pp 161–174Cite as

Is Autologous Transplantation for Non-Hodgkin’s Lymphoma Underutilized?

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

Abstract

Thousands of patients with a variety of malignancies have received high-dose chemo­therapy (HDCT) with autologous bone marrow transplantation (ABMT)/peripheral blood progenitor cell transplantation (PBPCT) over the past two decades. The use of ABMT in non-Hodgkin’s lymphoma (NHL) is an unequivocal success. AMBT now represents state-of-the-art care for many lymphoma patients, and has changed the standard of care for such patients worldwide. In the 1980s, clinical trials showed that ABMT potentially salvaged patients with relapsed/refractory NHL, who were otherwise destined to die of their disease. The superiority of transplantation over conventional therapy for relapsed intermediate and high-grade NHL has been confirmed in a landmark prospective randomized trial (Subheading 2.1). This data has confirmed the proof of principle that HDCT may, in fact, overcome tumor cells resistant to conventional-dose CT, and cure some patients who are otherwise incurable. With current techniques utilizing hematopoietic growth factors and PBPCs, mortality risks have decreased to 1–3%. The well-documented efficacy, coupled with decreased morbidity and mortality, have led to clinical research studies utilizing autologous stem cell transplantation (ASCT) for additional groups of patients with NHL, including those with intermediate- and high-grade NHL with poor prognostic factors in first remission, as well as those with poor-prognosis follicular NHL. This chapter briefly reviews autologous transplantation (autotransplantation) in NHL from a historical prospective, then discusses current indications for patients with relapsed/refractory intermediate- and high-grade NHL, and examines the potential utility of autotransplantation in follicular NHL, as well as for those patients with intermediate- and high-grade NHL with poor prognostic features at presentation.

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Authors
  1. Brian J. Bolwell MD
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Editors and Affiliations

  1. Bone Marrow Transplant Program, Department of Hematology/Medical Oncology, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Brian J. Bolwell MD (Director, Staff Physician) (Director, Staff Physician)

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© 2000 Humana Press Inc., Totowa, NJ

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Bolwell, B.J. (2000). Is Autologous Transplantation for Non-Hodgkin’s Lymphoma Underutilized?. In: Bolwell, B.J. (eds) Current Controversies in Bone Marrow Transplantation. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-657-7_12

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  • DOI: https://doi.org/10.1007/978-1-59259-657-7_12

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9812-7

  • Online ISBN: 978-1-59259-657-7

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