TY - JOUR
T1 - Nonmyeloablative allogeneic stem cell transplantation for non-hodgkin lymphoma
AU - Khouri, Issa F.
AU - Champlin, Richard E.
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - Allogeneic
KW - graft-versus-lymphoma
KW - lymphoma
KW - nonmyeloablative
UR - http://www.scopus.com/inward/record.url?scp=84866903964&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84866903964&partnerID=8YFLogxK
U2 - 10.1097/PPO.0b013e31826b124c
DO - 10.1097/PPO.0b013e31826b124c
M3 - Review article
C2 - 23006952
AN - SCOPUS:84866903964
SN - 1528-9117
VL - 18
SP - 457
EP - 462
JO - Cancer Journal (United States)
JF - Cancer Journal (United States)
IS - 5
ER -