Klin Onkol 2010; 23(3): 155-164.
Summary
Despite the undeniable progress in first-line treatment, a significant proportion of patients with lymphoproliferative disease still relapse. Transplant strategy is one of the most effective options for such patients. Autologous stem cell transplantation has for many years been the standard position in the treatment of chemosensitive relapse of diffuse large B cell lymphoma, Hodgkin‘s lymphoma and follicular lymphoma. Recently, autologous stem cell transplantation has had significant importance in first-line therapy of some T-cell lymphoma and mantle cell lymphoma as well. It is possible that this situation will change after the evaluation of clinical protocols using rituximab, either in first or second-line therapy or as part of the conditioning regimen and maintenance therapy. In recent years, there has also been a significant shift to the use of allogeneic transplantation, particularly through the introduction of so-called reduced intensity (RIC-alo). Many studies have demonstrated a significant reduction in mortality using RIC-alo, while preserving the GVL effect. In recent years, significant attention has also been focused on the identification of prognostic factors that could lead to earlier intensive therapy, including RIC-alo, particularly in mantle cell lymphoma, some T-cell lymphoma and Hodgkin‘s lymphoma. However, relapses remain a major problem of treatment failure and more accurate identification of patients suitable for early transplant strategy will be required.
