Intensive chemotherapy plus hematopoietic stem cells transplantation for relapsing non-Hodgkin's lymphoma: the GELA experience.

Prognosis of non-Hodgkin's aggressive lymphoma in relapse is very poor. Because of lymphoma high sensitivity to chemotherapy, intensive treatment followed by hematopoietic stem cells transplantation (SCT) could be an appropriate choice. Although randomized studies results are not yet available, evidence of favourable impact of intensive chemotherapy plus SCT was produced by retrospective studies. Our study on relapsing patients after LNH84 regimen showed a longer survival for transplanted patients in comparison with conventional chemotherapy treated patients. In follicular lymphomas after progression, a prolonged event free survival could be achieved at least when an effective marrow purging procedure was obtained. Despite mortality related to complications, allogenic bone marrow transplantation was followed by a low relapse rate suggesting a graft versus lymphoma effect. However, the majority of patients were treated by intensive chemotherapy with autologous stem cells rescue and a great challenge remains to decrease documented high relapse rate.