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Second hematopoietic SCT for lymphoma patients who relapse after autotransplantation: another autograft or switch to allograft?

Bone Marrow Transplantation volume 44, pages 559–569 (2009)Cite this article

Abstract

Although autologous hematopoietic SCT (auto-HSCT) is the only potentially curative treatment for lymphoma that has relapsed after conventional chemotherapy, the prognosis of patients with disease recurrence after auto-HSCT is poor. Some highly selected patients can benefit from second transplants. One-third with late recurrence after initial auto-HSCT may attain a prolonged remission after second auto-HSCT. Non-myeloablative or reduced-intensity conditioning (RIC) allogeneic hematopoietic SCT (allo-HSCT) has been used successfully after auto-HSCT failures, especially in subjects who have an HLA-compatible donor, chemosensitive disease and good performance status. Patients with chemosenstive disease recurrence who have completed at least 1 year after their first auto-HSCT should be considered for a second auto-HSCT. Patients who have chemoresistant disease are best served by participation in a well-designed clinical trial examining novel antitumor agents.

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Authors and Affiliations

  1. South Texas Veterans Health Care System, San Antonio, TX, USA

    C O Freytes

  2. Department of Medicine/Hematology and Medical Oncology, Unive,

    C O Freytes

  3. rsity of Texas Health Science Center, San Antonio, TX, USA

    C O Freytes

  4. Ireland Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    H M Lazarus

  5. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA

    H M Lazarus

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Correspondence to C O Freytes.

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Freytes, C., Lazarus, H. Second hematopoietic SCT for lymphoma patients who relapse after autotransplantation: another autograft or switch to allograft?. Bone Marrow Transplant 44, 559–569 (2009). https://doi.org/10.1038/bmt.2009.214

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