Autologous hematopoietic stem cell transplantation in non-hodgkin lymphomas

Non-HodgkinLymphomais aheterogeneous group oflymphoidmalignancies that involves mature B-cells, mature T-cells, and their progenitors. Although novel chemotherapy and immunotherapy regimens have improved rates of complete response and overall survival, autologous stem cell transplant (ASCT) is used in both the front-line and relapsed setting to further improve these markers and potentially cure. Even in indolent lymphomas, ASCT shows a definite improvement in progression-free survival, although no improvement in overall survival. The most promising results for front-line ASCT are in mantle cell lymphoma (MCL), where there is evidence of long-term progression-free and overall survival with evidence of a cured fraction. In the relapsed setting, ASCT is the standard of care in diffuse large B-cell lymphoma, though results of ASCT in the relapsed setting for MCL and Burkitt lymphoma are disappointing. The role and timing of ASCT in peripheral T-cell lymphomas are yet to be defined, but front-line ASCT in enteropathy-associated T-cell lymphoma and advanced-stage cutaneous T-cell lymphoma shows promise for improving long-term outcomes. Additional studies on front-line and relapsed ASCT with novel chemotherapy and immunotherapy regimens may demonstrate further improved responses and survival, especially for high-risk patients.