Hematopoietic stem cell transplantation for the management of follicular lymphoma

Although much has been published on the application of autologous and allogeneic hematopoietic stem cell transplantation in patients with follicular lymphoma (FL), no uniform consensus exists among physicians on when to use this strategy. Three large randomized trials failed to show a survival benefit using autologous transplantation for FL patients in first complete remission. Similarly, many Phase II or registry-based studies have also failed to show a survival benefit with autologous transplantation in relapsed or refractory FL patients, although the progression-free survival seems to be prolonged in transplant recipients. Allogeneic stem cell transplantation can cure a subset of patients with FL, but high nonrelapse mortality and morbidity remain a concern. No consensus exists on what conditioning regimen should be used, or how the newer monoclonal antibodies should be incorporated into the transplant paradigm. Here we present a review of the role of autologous and allogeneic hematopoietic stem cell transplantation in patients with FL.