Allogeneic hematopoietic stem cell transplantation for lymphoma.
For patients with relapsed or refractory Hodgkin's or non-Hodgkin's lymphomas, allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment option when autologous HSCT fails to achieve durable remission or is deemed inappropriate. Allogeneic HSCT can result in long-term survival even in patients with refractory lymphomas. The efficacy of allogeneic HSCT is attributed, at least in part, to an immune-mediated graft-versus-lymphoma (GVL) effect that can also be associated with significant toxicity resulting from graft-versus-host disease. However, clinical evidence of a potent GVL effect is inconsistent. Reduced-intensity conditioning before allogeneic HSCT can facilitate the use of this treatment in older patients and those at high risk. The decrease in toxicity with reduced-intensity regimens may be associated with a loss of antitumor effects. Patients with lymphoma should be selected for allogeneic HSCT on the basis of characteristics that strongly influence transplant outcomes, including histology, chemosensitivity, and donor source.
Dean
Robert M
RM
Experimental Transplantation and Immunology Branch Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA. robert.dean@nih.gov
Bishop
Michael R
MR
D018572:Disease-Free Survival; D020350:Graft vs Tumor Effect; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy; D020522:Lymphoma, Mantle-Cell / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D015337:Multicenter Studies as Topic; D011379:Prognosis; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome