Transplantation for non-Hodgkin lymphoma

High-dose therapy followed by autologous hematopoietic stem cell transplantation (auto-HCT) has become the treatment of choice for patients with relapsed aggressive non-Hodgkin lymphoma (NHL) However, relapse remains the most common cause of treatment failure after auto-HCT More intensive regimens incorporating radioimmunotherapy into high-dose regimens have been developed to prevent relapse The role of auto-HCT for follicular lymphoma and mantle cell lymphoma remain inconclusive Since prognosis of patients with peripheral T-cell lymphoma, not otherwise specified are very poor with conventional chemotherapy auto-HCT during first remission is being explored in peripheral T-cell lymphoma Given the lower risk of relapse after allogeneic HCT (allo-HCT) in NHL, allo-HCT has been performed in patients with refractory or relapsed NHL especially after auto-HCT failure However the transplant-related mortality remains high after myeloablative allo-HCT Reduced-intensity conditioning followed by allo-HCT has been shown to reduce transplant-related mortality but graft-versus-host disease continues to be the major problem, thus the role of allo-HCT in NHL remains an investigational approach for NHL The outcomes of auto-HCT and allo-HCT for various lymphomas are reviewed.