The role of autologous and allogeneic stem cell transplantation in the management of indolent B-cell lymphoma

John Kuruvilla


Despite improvements in the overall survival of patients with indolent non-Hodgkin's lymphoma over the past decade, these lymphomas remain largely incurable with standard therapies. Immunochemotherapy with rituximab-based regimens has become a well-established standard of care in the primary and relapsed disease settings. The role of haematopoietic stem cell transplantation in indolent lymphoma has been defined by the adoption of this therapy largely in the relapse setting as randomized trials in the front-line setting have not shown survival advantages. Allogeneic stem cell transplantation has the possibility for cure due to the potential for immunologic graft-versus-lymphoma effect but continues to have significant concerns with non-relapse mortality. Autologous transplantation offers a safe treatment platform but relapse remains a significant issue. The role of transplantation in the current treatment landscape of immunochemotherapy has not been conclusively proven and randomized trials are lacking. This review summarizes the relevant current data regarding transplantation in iNHL and highlights the issues relevant to clinicians in the field.

  • Submitted November 12, 2015.
  • Accepted February 24, 2016.