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Leukemia. 2015 Feb;29(2):464-73. doi: 10.1038/leu.2014.223. Epub 2014 Jul 18.

The EBMT/EMCL consensus project on the role of autologous and allogeneic stem cell transplantation in mantle cell lymphoma.

Author information

1
BMT Unit, University Hospital Bristol, Bristol, UK.
2
University of Heidelberg, Medizinische Klinik, Heidelberg, Germany.
3
Hospital Clínico Servicio de Hematologica, Salamanca, Spain.
4
Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milano, Milano, Italy.
5
BMT Unit, Rigshospitalet, Copenhagen, Denmark.
6
Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
7
CHU Nantes, Nantes, France.
8
Department Of Haematology, Karolinska University Hospital, Stockholm, Sweden.
9
Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, UK.
10
Department of Oncology and Hematology, 'Città della Salute e della Scienza' University Hospital, Torino, Italy.
11
Department of Haemato-Oncology, University of Munich, Munich, Germany.
12
Hôpital Necker, Service Hematologie Adulte, Paris, France.

Abstract

The role of both autologous (autoSCT) and allogeneic stem cell transplantation (alloSCT) in the management of mantle cell lymphoma (MCL) remains to be clarified. We conducted a consensus project using the RAND-modified Delphi consensus procedure to provide guidance on how SCT should be used in MCL. With regard to autoSCT, there was consensus in support of: autoSCT is the standard first-line consolidation therapy; induction therapy should include high-dose cytarabine and Rituximab; complete or partial remission should be achieved before autoSCT; Rituximab maintenance following autoSCT is not indicated; and omission of autoSCT in 'low-risk' patients is not indicated. No consensus could be reached regarding: autoSCT in the treatment of relapsed disease following non-transplant therapy; the value of positron emission tomography scanning and minimal residual disease (MRD) monitoring; in vivo purging with Rituximab; total body irradiation conditioning for autoSCT; and preemptive Rituximab after autoSCT. For alloSCT, consensus was reached in support of: alloSCT should be considered for patients relapsing after autoSCT; reduced intensity conditioning regimens should be used; allogeneic immunotherapy should be used for MRD eradication after alloSCT; and there is a lack of prognostic criteria to guide the use of alloSCT as first-line consolidation. No consensus was reached regarding the role of alloSCT for relapsed disease following non-transplant therapy.

PMID:
25034148
DOI:
10.1038/leu.2014.223
[Indexed for MEDLINE]

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