Indications for hematopoietic stem cell transplantation in patients with follicular lymphoma: a consensus project of the EBMT-Lymphoma Working Party

Silvia Montoto*, Paolo Corradini, Martin Dreyling, Michele Ghielmini, Eva Kimby, Armando Lopez-Guillermo, Stephen Mackinnon, Robert Marcus, Gilles Salles, Harry C. Schouten, Anna Sureda, Peter Dreger

*Corresponding author for this work

    Research output: Contribution to journalLiterature reviewpeer-review

    86 Citations (Scopus)

    Abstract

    The aim of this project was to define indications for hematopoietic stem cell transplantation in follicular lymphoma in Europe. In the absence of evidence-based data, a RAND-modified Delphi procedure was used by an expert panel. After pre-defining statements, these were individually/anonymously scored by each participant using a 9-point scale. Consensus was reached that: 1) high-dose therapy with autologous stem cell rescue is not an appropriate option to consolidate first remission in patients responding to immuno-chemotherapy outside clinical trials; 2) in patients with first chemo-sensitive relapse, high-dose therapy with autologous stem cell rescue is an appropriate option to consolidate remission, especially in patients with a short response after immuno-chemotherapy or with high-risk FLIPI; 3) high-dose therapy with autologous stem cell rescue is also appropriate in second/subsequent chemo-sensitive relapses; 4) allotransplant (preferably a reduced intensity conditioning-allotransplant) should be considered at relapse after high-dose therapy with autologous stem cell rescue. No consensus was reached on the role of high-dose therapy with autologous stem cell rescue in low-risk first relapse, or on when an allotransplant should be preferred over high-dose therapy with autologous stem cell rescue. In the absence of evidence-based data, the consensus method used was a valuable tool to define indications for hematopoietic stem cell transplant in follicular lymphoma.

    Original languageEnglish
    Pages (from-to)1014-1021
    Number of pages8
    JournalHaematologica
    Volume98
    Issue number7
    DOIs
    Publication statusPublished - Jul 2013

    Keywords

    • BONE-MARROW-TRANSPLANTATION
    • NON-HODGKINS-LYMPHOMA
    • CHRONIC LYMPHOCYTIC-LEUKEMIA
    • LOW-GRADE LYMPHOMA
    • HIGH-DOSE THERAPY
    • TERM-FOLLOW-UP
    • FREE SURVIVAL
    • ALLOGENEIC TRANSPLANTATION
    • PRACTICE GUIDELINES
    • PROGNOSTIC-FACTORS

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