Role of stem cell transplant in lymphoma in the era of new drugs

Purpose of review: Better understanding of the lymphoma pathogenesis and molecular biology has introduced a new era in the lymphoma therapy with the advent of targeted drugs. In this new era, the role of hematopoietic stem cell transplantation (HSCT) is evolving, and the purpose of this review is to demonstrate how the introduction of novel agents has affected the current treatment strategy of different subtypes of lymphoma. Recent findings: Autologous stem cell transplantation (ASCT) remains the standard of care for patients with relapsed Hodgkin Lymphoma and high-grade non-Hodgkin lymphoma (NHL). In the group of the indolent lymphomas, ASCT maintains its role in the relapsed setting. Novel targeted agents like idelalisib and ibrutinib have shown to induce prolonged remissions with a very good safety profile. However, the follow-up is still relatively short and none of these drugs have demonstrated a curative potential, as opposed to HSCT. Summary: For many authors, the advent of new targeted drugs is challenging the role of HSCT in different subsets of lymphoma. The actual challenge is how to make the best use of these drugs, in certain circumstances in combination with HSCT, to further improve the outcome of patients with lymphoma.

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