Bone marrow transplantation in chronic lymphocytic leukemia and lymphomas

Until recently younger patients with B-cell chronic lymphocytic leukemia (CLL) have not been considered for treatment with high-dose therapy and bone marrow transplantation (BMT). Current results show that both autologous and allogeneic bone marrow transplantation can induce a high percentage of long lasting remissions in younger patients with poor-risk CLL. Because of the investigational character of BMT for CLL, all eligible patients should be enrolled in clinical trials. Autologous BMT or peripheral blood stem cell transplantation (PSCT) have become standard therapies for relapsed patients with Hodgkin's disease (HD) or intermediate- and high-grade non-Hodgkin's lymphoma (NHL). Data on autologous transplantation for low-grade NHL are not mature enough and more experience is needed in order to assess the long-term value of such approach. Ongoing studies of high-dose therapy in lymphomas are focused on performing BMT earlier in the course of the disease and exploring alternative sources of hematopoietic rescue such as allogeneic stem cell transplantation.