Follicular non-Hodgkin lymphoma: long-term results of stem-cell transplantation.
OBJECTIVE
Hematopoietic stem-cell transplantation is an effective treatment option for follicular lymphoma. This review summarizes recent updates of the literature focusing on the available long-term follow-up of high-dose therapeutic approaches.


RESULTS
Autologous transplantation can prolong overall survival in relapsed disease and can extend progression-free survival in first remission. With more than 10 years of follow-up, the survival curves demonstrate a plateau indicating a potential cure in certain patients. Use of allogeneic transplantation may result in cure as well, but has been plagued by high treatment-related mortality rates when myeloablative conditioning is used. The decreased toxicity of reduced-intensity conditioning is more applicable to the older follicular lymphoma population, but long-term follow-up data are lacking.


CONCLUSIONS
For selected patients, both autologous and allogeneic transplantation offer the possibility of prolonged survival and can result in a cure in up to 25-45% of cases. It is unclear whether to incorporate monoclonal antibody or radioimmunoconjugate therapy. Stem-cell transplantation should at least be considered in patients younger than 60 years, possibly early in the disease course. Late consequences such as an increased risk of second malignancy may compromise this approach and close patient follow-up is essential.
Barr
Paul M
PM
Department of Medicine, Case Comprehensive Cancer Center, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
Lazarus
Hillard M
HM
D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D013997:Time Factors