Blood or marrow transplantation for mantle cell lymphoma.
OBJECTIVE
Mantle cell lymphoma is a generally incurable disease for which blood or marrow transplantation is frequently considered. This review assesses the more recent literature on high-dose therapeutic approaches for mantle cell lymphoma.


RESULTS
The benefit of transplantation is most apparent in first remission. Autologous transplantation can prolong event-free and possibly overall survival, although no plateau has been demonstrated in the survival curve. A randomized controlled trial demonstrated a significant event-free survival advantage to upfront autologous transplantation compared with interferon maintenance. The relative merit of autologous versus allogeneic transplantation remains to be better defined.


CONCLUSIONS
The role of transplantation for mantle cell lymphoma is controversial, as the impact on overall survival is unclear. Transplantation should be considered early in the disease course. Elimination of minimal residual disease through in-vivo purging of stem cells may translate into more durable remissions. Nonmyeloablative allogeneic transplantation and high-dose radioimmunotherapy are topics of ongoing investigation.
Kasamon
Yvette L
YL
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA. ykasamo1@jhmi.edu
D016026:Bone Marrow Transplantation; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000628:therapy*; D016499:Radioimmunotherapy; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous