Autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma

High-dose chemotherapy supported with autologous peripheral stem cell transplantation is now widely used in the treatment of lymphoma patients. The benefit of high-dose therapy has been clearly established after relapse in patients with an aggressive histological subtype who respond to salvage therapy. However, the use of such treatment also deserves further evaluation in the first line of therapy in patients with adverse prognostic factors. In follicular lymphoma, autologous transplantation seems able to induce long-term responses in selected clinical situations, but randomized studies are awaited to evaluate the potential benefit of this approach. In other lymphoma subtypes, the use of high-dose therapy remains experimental and should still be tested in clinical trials. Given the feasibility and the limited toxicity of autologous peripheral stem cell transplantation, the comparison of different therapeutic strategies (optimal timing, treatments modalities) will be facilitated and will allow us to assess the best ways of using this treatment in lymphoma patients.