title: Autologous stem cell transplantation for aggressive lymphomas.
abstract: The role of high-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) in the treatment armamentarium of aggressive B- and T-cell non-Hodgkin lymphoma (NHL) is still a matter of debate. In the pre-Rituximab era, the PARMA study demonstrated the superiority of HDT/ASCT over conventional salvage chemotherapy in chemosensitive, relapsed patients. Subsequently, HDT/ASCT has become a standard approach for relapsed NHL. With the advent of Rituximab in the landscape of NHL, transplantation as part of first-line therapy has been challenged. However, no benefit in terms of disease-free or overall survival of HDT/ASCT over standard therapy was shown when Rituximab was added to both arms. Moreover, the superiority of HDT/ASCT over conventional salvage therapy in patients relapsing from first-line therapy including Rituximab was not confirmed. From these disappointing results, novel strategies, which can enhance the anti-lymphoma effect, at the same time reducing toxicity have been developed, with the aim of improving the outcome of HDT/ASCT in aggressive NHL. In T-cell lymphoma, few publications demonstrated that consolidation of complete remission with HDT/ASCT is safe and feasible. However, up to one-third of patients may never receive transplant, mostly due to progressive disease, and relapse still remains a major concern even after transplant.
authors.affiliation: Hematology and Stem Cell Transplant Center, AORMN, Pesaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
authors.forename: Paola
authors.initials: P
authors.lastname: Picardi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Tosi
authors.forename: Roberta
authors.initials: R
authors.lastname: Gonella
authors.forename: Federica
authors.initials: F
authors.lastname: Loscocco
authors.forename: Teresa
authors.initials: T
authors.lastname: Ricciardi
authors.forename: Lara
authors.initials: L
authors.lastname: Malerba
authors.forename: Barbara
authors.initials: B
authors.lastname: Guiducci
authors.forename: Simona
authors.initials: S
authors.lastname: Tomassetti
authors.forename: Sara
authors.initials: S
authors.lastname: Barulli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Isidori