[Reduced-intensity stem cell transplantation (RIST) for lymphoproliferative diseases]

For lymphoproliferative disease, RIST is a curative treatment option. Here, we review the patients with follicular lymphoma(FL), diffuse large B cell lymphoma(DLBCL) and mantle cell lymphoma(MCL), who were mainly transplanted at Toranomon Hospital and National Cancer Center Hospital. In our series, 1-year disease-free survival rate were 100%, 56% and 63%, respectively. Main cause of death was treatment related mortality associated with graft-versus-host disease(GVHD) rather than disease progression in both DLBCL and MCL. These data suggest that intensified GVHD prophylaxis would improve the survival rates. We are now undergoing multi-center phase I/II study for RIST using fludarabine and busulfan. In designing our future study, we held nationwide survey to retrospectively evaluate the efficacy of RIST for various types of malignant lymphoma diseases. We also review the literature about RIST for acute lymphoblastic leukemia.