Reappraising the timing of transplant for indolent non-Hodgkin lymphomas

Expert Rev Hematol. 2016 Oct;9(10):951-64. doi: 10.1080/17474086.2016.1226128. Epub 2016 Aug 31.

Abstract

Introduction: Indolent non-Hodgkin lymphomas (iNHL) remain incurable with standard approaches. The timing of autologous stem cell transplant (ASCT) is changing following the introduction of new drugs that can potentially defer the transplant, improved reduced intensity conditioning (RIC) and haploidentical allogeneic SCT (allo-SCT).

Areas covered: The most relevant aspects concerning the role of hematopoietic stem cell transplantation in the management of iNHL are discussed. Literature search methodology included examination of PubMed index and meeting presentations. Expert commentary: ASCT is not currently employed as consolidation in first-line, being reserved to patients with refractory/relapsed disease. The curative potential of graft-versus-lymphoma (GVL) after RIC allo-SCT could be particularly beneficial in patients with iNHL relapsing after ASCT. This scenario could be modified in the near future by better definition of high-risk patients at diagnosis, by the improvement of minimal residual disease (MRD) evaluation and by the introduction of new drugs in the therapeutic algorithm.

Keywords: ASCT; NHL; allogeneic stem cell transplantation; follicular lymphoma; haploidentical stem cell transplantation; rituximab.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Drug Resistance, Neoplasm
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Lymphoma, Non-Hodgkin / diagnostic imaging
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / pathology
  • Lymphoma, Non-Hodgkin / therapy*
  • Neoplasm, Residual / diagnosis
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Recurrence
  • Remission Induction
  • Time-to-Treatment
  • Tissue Donors
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome