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The role of autologous hematopoietic stem cell transplantation in hematologic malignancy
Supraintensive cytoreductive therapy with hematopoietic stem cell rescue (HSCR) is able to provide curative therapy in a number of hematologic malignancies. Allogeneic HSCR is limited to less than 50% of patients because of the absence of related or unrelated compatible donors. Autologous HSCR is a viable alternative to allogeneic HSCR and is applicable to a greater number of patients. In addition, because of the absence of graft-versus-host disease, it is applicable to older patients. Although the relapse of malignancy is higher following autologous compared with allogeneic marrow, the disease-free survival for autologous HSCR is often equal to or greater than that seen following allogeneic HSCR. A number of posttransplantation immunological based therapies have shown promise for further decreasing the relapse rate following autologous HSCR.
Supraintensive cytoreductive therapy with hematopoietic stem cell rescue (HSCR) is able to provide curative therapy in a number of hematologic malignancies. Allogeneic HSCR is limited to less than 50% of patients because of the absence of related or unrelated compatible donors. Autologous HSCR is a viable alternative to allogeneic HSCR and is applicable to a greater number of patients. In addition, because of the absence of graft-versus-host disease, it is applicable to older patients. Although the relapse of malignancy is higher following autologous compared with allogeneic marrow, the disease-free survival for autologous HSCR is often equal to or greater than that seen following allogeneic HSCR. A number of posttransplantation immunological based therapies have shown promise for further decreasing the relapse rate following autologous HSCR.