Advancement in high dose therapy and autologous stem cell rescue in lymphoma.
Although advanced stage aggressive non-Hodgkin's lymphomas and Hodgkin's disease are thought to be chemotherapy-responsive cancers, a considerable number of patients either relapse or never attain a remission. High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is often the only possibility of cure for most of these patients. However, many controversial issues still remain with respect to HDT/ASCT for lymphomas, including its role for, the optimal timing of transplantation, the best conditioning regimen and the potential use of localized radiotherapy or immunologic methods to decrease post-transplant recurrence. Recently, mainly due to the unavailability of carmustine, several novel conditioning protocols have been clinically developed, with the aim of improving the overall outcome by enhancing the anti-lymphoma effect and, at the same time, by reducing short and long-term toxicity. Furthermore, the better safety profiles of novel approaches would definitively allow patients aged more than 65-70 years to benefit from this therapeutic option. In this review, we will briefly discuss the most relevant and recent data available regarding HDT/ASCT in lymphomas.
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Alessandro
A
Isidori
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Cristina
C
Clissa
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Federica
F
Loscocco
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Barbara
B
Guiducci
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Sara
S
Barulli
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Lara
L
Malerba
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Elisa
E
Gabucci
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy.
Giuseppe
G
Visani
Autologous stem cell transplantation; High dose therapy; Hodgkin lymphoma; New drugs; Non-Hodgkin lymphoma