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Is It Time to Revisit the Role of Allogeneic Transplantation in Lymphoma?

  • Satish Shanbhag
  • Nina Wagner-Johnston
  • Richard F. Ambinder
  • Richard J. JonesEmail author
Lymphomas (MR Smith, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lymphomas

Abstract

Purpose of Review

A multitude of new drug and cell therapy approvals for lymphoma has prompted questions about the role of allogeneic blood or marrow transplantation (allo-BMT). We sought to review the latest evidence examining the role of allo-BMT for lymphoma in this evolving landscape.

Recent Findings

Despite several new drug classes, there remains a large unmet need, particularly in hard to treat subtypes of lymphoma and for patients with relapsed/refractory disease. Allo-BMT can provide an opportunity for cure due to a potent graft vs lymphoma effect in high-risk relapse/refractory follicular lymphoma, mantle cell lymphoma, and aggressive T cell lymphomas. Chimeric antigen receptor T cell therapy and checkpoint blockers have improved outcomes for patients with relapsed /aggressive B cell lymphomas and Hodgkin lymphoma respectively; the role of allo-BMT consolidation in the treatment algorithm for responders to these therapies is an evolving topic.

Summary

Expanded donor availability including haploidentical relatives has improved access to allo-BMT. Non-myeloablative conditioning regimens and post-transplant cyclophosphamide prophylaxis have improved early transplant-related morbidity and rates of graft versus host disease and translated into long-term survival for patients with lymphoid malignancies. Patient selection remains key, but allo-BMT remains the only modality able to deliver durable long-term remissions across different types of lymphoma.

Keywords

Allogeneic transplant Lymphoma Diffuse large B cell lymphoma Graft-versus-lymphoma effect Graft vs host disease Hodgkin lymphoma Mantle cell lymphoma Non-Hodgkin lymphoma 

Notes

Compliance with Ethical Standards

Conflict of Interest

Satish Shanbhag has received institutional research support from America Regent/Daiichi-Sankyo and participated on an advisory board for Takeda.

Nina Wagner-Johnston has participated on advisory boards for Bayer and Gilead.

Richard F. Ambinder declares that he has no conflict of interest.

Richard J. Jones declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Satish Shanbhag
    • 1
    • 2
  • Nina Wagner-Johnston
    • 1
  • Richard F. Ambinder
    • 1
  • Richard J. Jones
    • 1
    Email author
  1. 1.Department of Oncology, The Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Division of Hematology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreUSA

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