Summary

Allo SCT has begun to assume an increasing role in the management of NHL. This approach provides several advantages over auto SCT, including provision of a lymphoma-free graft, reduced rates of secondary myelodysplastic syndrome and leukemia, and a potentially curative GvL effect. The latter appears to be considerably more pronounced in low-grade NHL such as follicular NHL, compared to more aggressive histologies. When applied to chemosensitive patients, the lower relapse rates and reasonable long-term outcomes make allo SCT a promising therapy to pursue. Patient populations, such as those with bone marrow involvement or very high-risk disease, can be identified as having suboptimal outcomes after auto SCT and may benefit from such an approach. While the exact role of allo SCT remains to be determined, broad recommendations can be suggested for the management of patients with NHL. New approaches to allo SCT, including the use of matched-unrelated donors and reduced-intensity conditioning regimens, may expand the applicability of this potentially curative modality.

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