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 E. Marcus, Gilles Salles, Harry C. Schouten, Anna Sureda, Peter Dreger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

70 Citations (Web of Science)

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
JournalHaematologica-the Hematology Journal
Volume98
Issue number7
DOIs
Publication statusPublished - Jul 2013

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