Table 4.
Recommendations based on current evidence and expert opinion, on the role of hematopoietic cell transplantation in follicular lymphoma.
| Status of FL | Type of HCT | Recommendations |
|---|---|---|
| First remission as consolidative therapy | HDT-autologous HCT | Not recommended. |
| Allogeneic HCT | Not recommended. | |
|
| ||
| HDT-autologous HCT | Consider for patients with chemosensitive disease, and ≤2-3 lines of prior therapies. | |
| Relapsed/refractory FL | Myeloablative allogeneic HCT | Best reserved for medically fit younger patients with refractory disease. |
| RIC allogeneic HCT | Recommended for appropriately selected relapsed/refractory patients. | |
|
| ||
| FL after histological transformation | HDT-autologous HCT | Appropriate for patients with chemosensitive disease. Ideally on a clinical trial. |
| Allogeneic HCT | Consider for fit patients with refractory relapse, bone marrow involvement, and history of prior autologous HCT. Ideally on a clinical trial. |
|
Abbreviations: FL: follicular lymphoma; HCT: hematopoietic cell transplantation; HDT: high-dose therapy; RIC: reduced intensity conditioning; RCT: randomized controlled trials; OS: overall survival; PFS: progression-free survival; TBI: total body irradiation; TRM: treatment-related mortality; URD: unrelated donor.