Umar Zahid1,2, Faisal Akbar3, Akshay Amaraneni4, Muhammad Husnain5, Onyee Chan5, Irbaz Bin Riaz1, Ali McBride6, Ahmad Iftikhar7, Faiz Anwer8,9. 1. Department of Medicine, University of Arizona, Tucson, AZ, USA. 2. College of Public Health, University of Arizona, Tucson, AZ, USA. 3. Department of Medicine, Wake Forest Baptist Medical Center, Winston Salem, NC, USA. 4. Department of Medicine, Hematology and Oncology, University of Arizona, Tucson, AZ, USA. 5. Internal medicine Residency program, Department of Medicine, University of Arizona, Tucson, AZ, USA. 6. College of Pharmacy, University of Arizona, Tucson, AZ, USA. 7. Department of Hematology and Oncology, University of Arizona, Tucson, AZ, USA. 8. Department of medicine, Hematology Oncology and Arizona Cancer Center, University of Arizona, Tucson, AZ, USA. anwerf@email.arizona.edu. 9. Department of Medicine, Division of Hematology, Oncology, Blood & Marrow Transplantation, Multiple Myeloma Program, University of Arizona, Tucson, AZ, 85721, USA. anwerf@email.arizona.edu.
Abstract
PURPOSE OF REVIEW: Chemotherapy remains the first-line therapy for aggressive lymphomas. However, 20-30% of patients with non-Hodgkin lymphoma (NHL) and 15% with Hodgkin lymphoma (HL) recur after initial therapy. We want to explore the role of high-dose chemotherapy (HDT) and autologous stem cell transplant (ASCT) for these patients. RECENT FINDINGS: There is some utility of upfront consolidation for-high risk/high-grade B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma, but there is no role of similar intervention for HL. New conditioning regimens are being investigated which have demonstrated an improved safety profile without compromising the myeloablative efficiency for relapsed or refractory HL. Salvage chemotherapy followed by HDT and rescue autologous stem cell transplant remains the standard of care for relapsed/refractory lymphoma. The role of novel agents to improve disease-related parameters remains to be elucidated in frontline induction, disease salvage, and high-dose consolidation or in the maintenance setting.
PURPOSE OF REVIEW: Chemotherapy remains the first-line therapy for aggressive lymphomas. However, 20-30% of patients with non-Hodgkin lymphoma (NHL) and 15% with Hodgkin lymphoma (HL) recur after initial therapy. We want to explore the role of high-dose chemotherapy (HDT) and autologous stem cell transplant (ASCT) for these patients. RECENT FINDINGS: There is some utility of upfront consolidation for-high risk/high-grade B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma, but there is no role of similar intervention for HL. New conditioning regimens are being investigated which have demonstrated an improved safety profile without compromising the myeloablative efficiency for relapsed or refractory HL. Salvage chemotherapy followed by HDT and rescue autologous stem cell transplant remains the standard of care for relapsed/refractory lymphoma. The role of novel agents to improve disease-related parameters remains to be elucidated in frontline induction, disease salvage, and high-dose consolidation or in the maintenance setting.
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