title: Stem cell transplantation for diffuse large B-cell lymphoma patients in the rituximab era.
abstract: OBJECTIVE
  Addition of rituximab to conventional chemotherapies was shown to improve outcome in phase 3 trials of patients with diffuse large B-cell lymphoma (DLBCL). As the challenge in the rituximab era is to increase treatment efficacy, the present review attempts to assess the results of high-dose therapy and autologous stem cell transplantation (ASCT) as front-line treatment for poor-prognosis DLBCL patients.
  
  
  RESULTS
  French and Italian groups demonstrated in several phase 2 series that high-dose front-line treatment with rituximab plus ASCT gave better results than without rituximab. In relapse, the CORAL study, a worldwide collaborative effort, showed that assessment of the latest results for ASCT should also take account of other prognostic factors, including advanced stage, chemo/rituximab refractory disease and a short interval between remission and relapse. This underscores the need for innovative therapeutic strategies such as radiolabelled conditioning regimens and maintenance after ASCT. Allogeneic transplantation, which generates a graft-versus-lymphoma effect that reduces the likelihood of relapse, may also be beneficial for high-risk patients.
  
  
  CONCLUSIONS
  In this setting, new approaches based on improved understanding of the biology of the disease will play a key role.
authors.affiliation: Service d'Onco-Hématologie, Hôpital de l'Archet, Nice, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mounier
authors.forename: Christian
authors.initials: C
authors.lastname: Gisselbrecht
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000069283:Rituximab; D033581:Stem Cell Transplantation / Q000379:methods*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab