title: Allogeneic stem cell transplantation in mantle cell lymphoma: where are we now and which way should we go?
abstract: Despite the use of intensive chemotherapy regimens with or without autologous stem cell transplant (auto-SCT) support, the clinical course of mantle cell lymphoma (MCL) remains characterized by iterative relapses and is still an incurable disease. The impact of allogeneic stem cell transplantation (allo-SCT) in MCL emerged in the late 1990s when it was shown that myeloablative allo-SCT could potentially cure some relapsed/refractory MCL patients. This curative impact is sustained by a graft-versus-disease (GVD-MCL) effect. However, toxicity and mortality following myeloablative allo-SCT are too high and have limited its use for patients aged under 65 years at diagnosis. Reduced-intensity conditioning regimens (RIC-allo) entail lower toxicity and reduced transplant-related mortality (TRM), making allogeneic transplant a valid option for a larger MCL population. At present, RIC-allo should be considered a valid therapeutic option for relapsed MCL patients and innovative therapeutic strategies including RIC-allo need to be investigated. Herein, the role of GVD-MCL and place of allo-SCT in MCL is discussed, taking into account the most recent literature, and several ways to improve RIC-allo in MCL that deserve to be explored are presented.
authors.affiliation: Service d'hématologie clinique du CHU de Nantes, Nantes, France. steven.legouill@chu-nantes.fr
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Thierry
authors.initials: T
authors.lastname: Guillaume
authors.forename: Thomas
authors.initials: T
authors.lastname: Gastinne
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
mesh_terms: D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000639:trends; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000601:surgery*; D014184:Transplantation, Homologous; D016896:Treatment Outcome