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Is It Time to Revisit the Role of Allogeneic Transplantation in Lymphoma?

  • Lymphomas (MR Smith, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

A multitude of new drug and cell therapy approvals for lymphoma has prompted questions about the role of allogeneic blood or marrow transplantation (allo-BMT). We sought to review the latest evidence examining the role of allo-BMT for lymphoma in this evolving landscape.

Recent Findings

Despite several new drug classes, there remains a large unmet need, particularly in hard to treat subtypes of lymphoma and for patients with relapsed/refractory disease. Allo-BMT can provide an opportunity for cure due to a potent graft vs lymphoma effect in high-risk relapse/refractory follicular lymphoma, mantle cell lymphoma, and aggressive T cell lymphomas. Chimeric antigen receptor T cell therapy and checkpoint blockers have improved outcomes for patients with relapsed /aggressive B cell lymphomas and Hodgkin lymphoma respectively; the role of allo-BMT consolidation in the treatment algorithm for responders to these therapies is an evolving topic.

Summary

Expanded donor availability including haploidentical relatives has improved access to allo-BMT. Non-myeloablative conditioning regimens and post-transplant cyclophosphamide prophylaxis have improved early transplant-related morbidity and rates of graft versus host disease and translated into long-term survival for patients with lymphoid malignancies. Patient selection remains key, but allo-BMT remains the only modality able to deliver durable long-term remissions across different types of lymphoma.

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  1. Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Room 244, Bunting-Blaustein Cancer Research Bldg., 1650 Orleans Street, Baltimore, MD, 21231, USA

    Satish Shanbhag, Nina Wagner-Johnston, Richard F. Ambinder & Richard J. Jones

  2. Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Satish Shanbhag

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  1. Satish Shanbhag
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Satish Shanbhag has received institutional research support from America Regent/Daiichi-Sankyo and participated on an advisory board for Takeda.

Nina Wagner-Johnston has participated on advisory boards for Bayer and Gilead.

Richard F. Ambinder declares that he has no conflict of interest.

Richard J. Jones declares that he has no conflict of interest.

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Shanbhag, S., Wagner-Johnston, N., Ambinder, R.F. et al. Is It Time to Revisit the Role of Allogeneic Transplantation in Lymphoma?. Curr Oncol Rep 21, 65 (2019). https://doi.org/10.1007/s11912-019-0809-z

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