Controversies and Recent Advances in Hematopoietic Cell Transplantation for Follicular Non-Hodgkin Lymphoma

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.