Lymphoplasmacytic lymphomas are low grade Non-Hodgkin’s lymphomas and contain small lymphocytes, plasmacytoid lymphocytes, variable numbers of transformed cells, and plasma cells. It is the nodal; equivalent of Waldenstrom’s (WM) macroglobulinemia. The question that needs to be addressed in the medical appropriateness of allogeneic transplantation and the proposed conditioning regimens for a low grade lymphoma as well as the disease specific question. In general, the literature does not confirm effectiveness of allogeneic transpalntation for indolent lymphomas. Encouraging evidence is accumulating for the efficacy of reduced intensity transplantation in indolent lymphoproliferative disorders. Allogeneic graft-versus-malignancy effects can be demonstrated and durable responses to donor lymphocytes are being reported. More follow-up is required, however, before the curative potential of allogeneic transplantation can be confirmed or generally accepted.
Only restrospective sereis are available for waldenstrom’s; they establish that Stem Cell Transplants is feasible in WM and long-term disease control can be achieved in selected patients with autologous or allogeneic SCT, even in those with refractory disease. A 2006 review, however, concluded: “Allogeneic SCT carries a much higher (40%) risk of Non Relapse Motality and should not be considered outside the context of a clinical trial.”
A . Anagnostopoulos , A . Aleman , S . Giralt Autologous and allogeneic stem cell transplantation in Waldenstrom’s macroglobulinemia: Review of the literature and future directions . Seminars in Oncology , Volume 30 , Issue 2 , Pages 286 – 290
Athanasios Anagnostopoulos, Parameswaran N Hari, Waleska S Pérez, Karen Ballen, Asad Bashey, Christopher N Bredeson, César O Freytes, Robert Peter Gale, Morie A Gertz, John Gibson, Hartmut Goldschmidt, Hillard M Lazarus, Philip L McCarthy, Donna E Reece, David H Vesole, Sergio A Giralt Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom’s Macroglobulinemia.Biol Blood Marrow Transplant. 2006 Aug ;12 (8):845-54
Thomson KJ, Mackinnon S. Role of allogeneic transplantation in low-grade lymphoma and chronic lymphocytic leukemia. Curr Opin Hematol. 2006 Jul;13(4):273-9.