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Biol Blood Marrow Transplant. 2010 Apr;16(4):443-68. Epub 2010 Jan 28.
The role of cytotoxic therapy with hematopoietic stem cell transplantation in the treatment of follicular lymphoma:
an evidence-based review.
Oliansky DM, Gordon LI, King J, Laport G, Leonard JP, McLaughlin P, Soiffer RJ, van Besien KW, Werner M, Jones RB, McCarthy PL Jr, Hahn T.
Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Abstract
Clinical research examining the role of hematopoietic stem cell transplantation (SCT) in the therapy of follicular non-Hodgkin lymphoma in adults is presented and critically evaluated in this systematic evidence-based review.
Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the treatment recommendations.
Treatment recommendations reached unanimously by a panel of follicular lymphoma experts are:
(1) autologous SCT is recommended as salvage therapy based on pre-rituximab data, with a significant improvement in overall survival (OS) and progression-free (PFS) survival;
(2) autologous SCT is not recommended as first-line treatment for most patients because of no significant improvement in OS;
(3) autologous SCT is recommended for transformed follicular lymphoma patients;
(4) reduced intensity conditioning before allogeneic SCT appears to be an acceptable alternative to myeloablative regimens;
(5) an HLA-matched unrelated donor appears to be as effective an HLA-matched related donor for reduced intensity conditioning allogeneic SCT. There are insufficient data to make a recommendation on the use of autologous SCT after rituximab-based salvage therapy.
[Count em] Eleven areas of needed research in the treatment of follicular lymphoma with SCT were identified and are presented in the review.
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