Stem cell transplantation for diffuse large B-cell lymphoma patients in the rituximab era

作者：Mounier Nicolas; Gisselbrecht Christian^*

来源：Current Opinion in Oncology, 2011, 23(2): 209-213.

DOI：10.1097/CCO.0b013e328342b8ad

• diffuse large B-cell lymphoma
• high-dose chemotherapy
• rituximab
• stem cell transplantation

Purpose of review
Addition of rituximab to conventional chemotherapies was shown to improve outcome in phase 3 trials of patients with diffuse large B-cell lymphoma (DLBCL). As the challenge in the rituximab era is to increase treatment efficacy, the present review attempts to assess the results of high-dose therapy and autologous stem cell transplantation (ASCT) as front-line treatment for poor-prognosis DLBCL patients.
Recent findings
French and Italian groups demonstrated in several phase 2 series that high-dose front-line treatment with rituximab plus ASCT gave better results than without rituximab. In relapse, the CORAL study, a worldwide collaborative effort, showed that assessment of the latest results for ASCT should also take account of other prognostic factors, including advanced stage, chemo/rituximab refractory disease and a short interval between remission and relapse. This underscores the need for innovative therapeutic strategies such as radiolabelled conditioning regimens and maintenance after ASCT. Allogeneic transplantation, which generates a graft-versus-lymphoma effect that reduces the likelihood of relapse, may also be beneficial for high-risk patients.
Summary
In this setting, new approaches based on improved understanding of the biology of the disease will play a key role.

• 出版日期2011-3