Reduced-intensity conditioning allogeneic stem cell transplantation in malignant lymphoma: current status

(整期优先)网络出版时间:2013-01-11
/ 1
Allogeneicstemcelltransplantation(allo-SCT)isapotentialcureforpatientswithmalignantlymphomathatisbasedonthegraft-versus-lymphoma(GVL)effect.Myeloablativeconditioningallo-SCTisassociatedwithhighmortalityandmorbidity,particularlyinpatientsolderthan45years,heavilypretreatedpatients(priorhematopoieticstemcelltransplantationormorethantwolinesofconventionalchemotherapy)orpatientsaffectedbyothercomorbidities.Therefore,conventionalallo-SCTisrestrictedtoyoungerpatients(<50to55years)ingoodphysicalcondition.Overthelastdecade,allo-SCTwithreduced-intensityconditioning(RIC-allo-SCT)hasbeenincreasinglyusedtotreatpatientswithlymphoma.Thistreatmentisassociatedwithlowertoxicityandsubstantialdecreaseintheincidenceoftransplant-relatedmortality,andhasthepotentialtoleadtolong-termremissions.Therefore,patientswhoarenotsuitabletoundergoconventionalallo-SCTcanbenefitfromthepotentiallycurativeGVLeffectsofallo-SCT.AlthoughRIC-allo-SCThasimprovedthesurvivaloflymphomapatients,highpost-transplantrelapseratesordiseaseprogressionmainlyresultsintreatmentfailure.Thus,furtherimprovementisclearlyneeded.TheroleandtimingofRIC-allo-SCTinthetreatmentoflymphomaremainsunclear.Therefore,moreprospectivestudiesshouldclarifytheeffectivenessofthismethod.Inthisarticle,wereviewtherecentliteratureonRIC-allo-SCTasatreatmentformajorlymphomasubtypes.Areasthatrequirefurtherinvestigationinthecontextofclinicaltrialsarealsohighlighted.