Therapy For Specific Nhl Subtypes

NHLs are a heterogeneous group of lymphoid malignancies whose clinical behavior and response to therapy exhibit considerable variation. Mantle-cell NHL, for example, resembles a low-grade NHL morphologically, behaves aggressively, yet is incurable using conventional therapies. Use of auto SCT in mantle-cell NHL in relapse provides extremely poor prospects of attaining long-term disease-free survival.52 Martinez et al.53 and Grigg and colleagues54 reported series in which allo SCT salvaged such patients, due in large part to the contribution of GvL when GvHD develops. Examples of other successful initiates already have been related earlier in this review. Further support for GvL in this context is the report from Berdeja and colleagues55 who noted poorer survival in mantle-cell NHL patients compared to other histologic types; these patients received T-cell depleted grafts that compromise the GvL effect.

Peripheral T-cell NHL represents a less common, more resistant histologic subtype, one in which the

Table 65.9 Studies using reduced-intensity conditioning and allo SCT as first transplant for follicular NHL

References

No. of patients

Conditioning

Median follow-up

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