Graft-versus-tumor effect in autologous setting: fact or fallacy?

Autologous hematopoietic cell transplantation (AHCT) is usually considered a single high-dose therapy intending to eradicate existing malignant cells from the patient and enabling both hematologic and immune recovery after the graft infusion. In addition to tumor biology and disease status, also the immunologic status of the patient and several factors affecting graft cellular content are crucial for posttransplant outcomes. There is evidence for an immunotherapeutic role of immune effector cells within infused grafts and of importance of immune recovery post-transplant. Here we present the pros and cons of this autograft-versus-tumor effect in myeloma and non-Hodgkin lymphoma, the two most common current indications for AHCT. In addition, we discuss ways to potentially improve current treatment results by enhancing the immunotherapeutic effect of AHCT.