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Review
. 2012 Sep-Oct;18(5):457-62.
doi: 10.1097/PPO.0b013e31826b124c.

Nonmyeloablative allogeneic stem cell transplantation for non-hodgkin lymphoma

Issa F Khouri  1 , Richard E Champlin
Affiliations
Review

Nonmyeloablative allogeneic stem cell transplantation for non-hodgkin lymphoma

Issa F Khouri et al. Cancer J. 2012 Sep-Oct.

Abstract

Non-Hodgkin lymphomas constitute a heterogeneous group of hematologic malignancies with varying aggressiveness and many therapeutic options. Nonmyeloablative (NMA) conditioning has been the cornerstone of allogeneic adoptive immunotherapy for these diseases. This approach utilizes a reduced intensity preparative regimen to achieve engraftment with little toxicity. This allows for development of the immune graft-versus-lymphoma effect. Results depend on the histologic type of lymphoma, prognostic factors, patient characteristics, and chemosensitivity. For follicular lymphomas, NMA transplants are highly effective in patients with refractory or recurrent disease after the best chemoimmunotherapy available and who have a matched sibling or unrelated donor. In mantle cell lymphoma, autologous stem cell transplants are generally ineffective for patients with recurrent disease; we reported 6-year actuarial progression-free survival rate of 46%, using NMA allogeneic transplants. The indications of NMA transplants for diffuse large B-cell lymphoma and T-cell lymphomas are controversial; success has been reported in selected high-risk patients and those relapsing after an autologous transplantation who have chemosensitive disease. Considerations for the conditioning regimen, donor source, graft-versus-host disease prophylaxis, donor lymphocyte infusion, and relapse prevention methods are reviewed.

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Figures

Figure 1
Figure 1
Progression-free survival after NMA allogeneic SCT in relapsed MCL patients according to the number of prior therapies
See this image and copyright information in PMC

References

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    1. Khouri IF, Saliba RM, Hosing C, Okoroji GJ, et al. Concurrent administration of high-dose rituximab before and after autologous stem-cell transplantation for relapsed aggressive B-cell non-Hodgkin's lymphomas. J Clin Oncol. 2005;23:2240–2247. - PubMed

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