Autologous stem cell transplants in lymphomas

Hodgkin's disease and non-Hodgkin's lymphomas can be treated and, in a large number of cases, cured by first-line chemotherapy or radiotherapy. Unlike many other malignancies, relapse is not uniformly fatal but the treatment is usually markedly myelotoxic with the high doses of chemotherapy used in relapse. Haematopoietic reconstitution with either autologous marrow or peripheral stem cells postchemotherapy has made high-dose chemotherapy relatively safe with mortality rates as low as 2% in some centres. The clinical indications for high-dose therapy in lymphoma management for patients with relapsed and bad prognosis disease are reviewed. The advantages of autologous bone marrow and peripheral stem cell transplants are compared and current peripheral stem cell mobilization and harvesting practice is discussed.