Hematopoietic stem cell transplantation for non-Hodgkin's lymphoma

High-dose myeloablative therapy with autologous or allogeneic stem cell rescue is an effective treatment strategy for non-Hodgkin's lymphoma (NHL), but NHL is much less likely to stay in remission after an autologous transplant than after an allogeneic transplant. The benefit of undergoing an autologous transplant earlier in the course of the disease, especially for patients who present with intermediate or high scores on the International Prognostic Index of risk factors, is still unclear. The addition of immunotherapy, biologic modifiers, and antibody therapy such as rituximab (Rituxan) or radiolabeled antibody to the autologous transplant are approaches undergoing evaluation. Historically, there has been a high regimen-related mortality rate associated with myeloablative allogeneic transplant that has made this approach a less appealing option for therapy. The use of nonmyeloablative allogeneic transplants as treatment for NHL is less well studied and remains to be defined.