[High dose chemotherapy followed by hematopoietic stem cell transplantation for malignant lymphoma]

The role of high dose chemotherapy followed by hematopoietic stem cell transplantation in malignant lymphoma is discussed in comparison with the present state-of-the-art chemotherapy. Very recently, Parma randomized study revealed the apparent survival advantage of high dose chemotherapy in relapsed aggressive lymphoma patients who showed chemosensitivity to DHAP salvage therapy. Another randomized study conducted in UK showed the efficacy of high dose chemotherapy in relapsed or recurrent Hodgkin's disease. Therefore, it is generally accepted that patients with aggressive lymphoma or Hodgkin's disease who are chemosensitive to salvage chemotherapy at relapse are appropriate candidates for high dose chemotherapy. Although it is unclear that those with high-risk aggressive lymphoma will benefit from high dose chemotherapy in an up front setting, this strategy is expected to be the most promising one at the present time to improve the poor prognosis of such patients. To determine the exact role of high dose chemotherapy in malignant lymphoma and address the various questions, consecutive well-designed clinical trials should be conducted.