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World J Stem Cells. Aug 26, 2015; 7(7): 1039-1046
Published online Aug 26, 2015. doi: 10.4252/wjsc.v7.i7.1039
Advancement in high dose therapy and autologous stem cell rescue in lymphoma
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani
Alessandro Isidori, Cristina Clissa, Federica Loscocco, Barbara Guiducci, Sara Barulli, Lara Malerba, Elisa Gabucci, Giuseppe Visani, Haematology and Haematopoietic Stem Cell Transplant Center, AORMN, 61100 Pesaro, Italy
Author contributions: Isidori A, Clissa C and Loscocco F contributed equally to this work, generated the tables and wrote the manuscript; all authors contributed to the concept, drafting, revising and final editing of this manuscript; Visani G made critical revisions related to important intellectual content of the manuscript.
Conflict-of-interest statement: The authors declare no competing financial interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alessandro Isidori, MD, PhD, Haematology and Haematopoietic Stem Cell Transplant Center, Marche Nord Hospital, Via Lombroso, 61100 Pesaro, Italy. asidori@gmail.com
Telephone: +39-721-364022 Fax: +39-721-364026
Received: November 25, 2014
Peer-review started: November 26, 2014
First decision: January 8, 2015
Revised: May 18, 2015
Accepted: July 16, 2015
Article in press: July 19, 2015
Published online: August 26, 2015
Abstract

Although advanced stage aggressive non-Hodgkin’s lymphomas and Hodgkin’s disease are thought to be chemotherapy-responsive cancers, a considerable number of patients either relapse or never attain a remission. High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is often the only possibility of cure for most of these patients. However, many controversial issues still remain with respect to HDT/ASCT for lymphomas, including its role for, the optimal timing of transplantation, the best conditioning regimen and the potential use of localized radiotherapy or immunologic methods to decrease post-transplant recurrence. Recently, mainly due to the unavailability of carmustine, several novel conditioning protocols have been clinically developed, with the aim of improving the overall outcome by enhancing the anti-lymphoma effect and, at the same time, by reducing short and long-term toxicity. Furthermore, the better safety profiles of novel approaches would definitively allow patients aged more than 65-70 years to benefit from this therapeutic option. In this review, we will briefly discuss the most relevant and recent data available regarding HDT/ASCT in lymphomas.

Keywords: Hodgkin lymphoma, Non-Hodgkin lymphoma, High dose therapy, Autologous stem cell transplantation, New drugs

Core tip: High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is considered the golden standard for the vast majority of patients with both Hodgkin and non-Hodgkin lymphoma, who either relapse or never attain a remission. However, several questions about HDT/ASCT still remain unanswered, also comprising, but not limited to, its role in newly diagnosed patients with advanced stage disease. The incorporation of novel drugs in both salvage and conditioning regimens has recently revitalized the HDT/ASCT area, with several phase I-II trials performed during the last 5 years. This review will focus on the most recent data regarding HDT/ASCT in lymphomas.