TY - JOUR
T1 - The role of stem cell transplantation in Waldenstrom's macroglobulinemia
AU - Chakraborty, Rajshekhar
AU - Muchtar, Eli
AU - Gertz, Morie A.
N1 - Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Waldenstrom's macroglobulinemia (WM) is an indolent B-cell lymphoma, which is highly chemosensitive, with an overall response rate over 90% to novel agents. However, most patients eventually relapse after response to first-line chemotherapy, necessitating further treatment. The possibility of long-lasting remission after high-dose cytotoxic chemotherapy followed by stem cell rescue is high in WM due to the chemosensitive nature of the disease and lower proliferative activity compared to multiple myeloma. In this paper, we have reviewed current evidence on autologous (auto-) and allogeneic (allo-) stem cell transplantation (SCT) in WM. Auto-SCT can be safely performed in WM and is recommended as second-line treatment or beyond in eligible patients. It is associated with extremely low transplant-related mortality. Allo-SCT is effective in WM with incremental benefit due to graft-versus-WM effect, but is associated with high non-relapse mortality of 30%, hence should be preferably considered investigational as part of clinical trials in selected patients who have exhausted other treatment options.
AB - Waldenstrom's macroglobulinemia (WM) is an indolent B-cell lymphoma, which is highly chemosensitive, with an overall response rate over 90% to novel agents. However, most patients eventually relapse after response to first-line chemotherapy, necessitating further treatment. The possibility of long-lasting remission after high-dose cytotoxic chemotherapy followed by stem cell rescue is high in WM due to the chemosensitive nature of the disease and lower proliferative activity compared to multiple myeloma. In this paper, we have reviewed current evidence on autologous (auto-) and allogeneic (allo-) stem cell transplantation (SCT) in WM. Auto-SCT can be safely performed in WM and is recommended as second-line treatment or beyond in eligible patients. It is associated with extremely low transplant-related mortality. Allo-SCT is effective in WM with incremental benefit due to graft-versus-WM effect, but is associated with high non-relapse mortality of 30%, hence should be preferably considered investigational as part of clinical trials in selected patients who have exhausted other treatment options.
KW - Allogeneic stem cell transplantation
KW - Autologous stem cell transplantation
KW - Waldenstrom's macroglobulinemia
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U2 - 10.1016/j.beha.2016.08.018
DO - 10.1016/j.beha.2016.08.018
M3 - Review article
C2 - 27825469
AN - SCOPUS:84994478254
SN - 1521-6926
VL - 29
SP - 229
EP - 240
JO - Best Practice and Research: Clinical Haematology
JF - Best Practice and Research: Clinical Haematology
IS - 2
ER -