Tandem transplantation in lymphoma

The majority of poor-risk lymphoma patients are not cured with conventional chemotherapy. There is evidence for the superiority of single high-dose ch emotherapy in such patients, but many still die from recurrent disease. Str ategies to improve survival in these poor-risk patients include dose-intens ification with high-dose chemotherapy and PBPC support, tandem autologous H DC with PBPC support, and autologous followed by non-myeloablative allogene ic transplantation. These more aggressive strategies are feasible and toler able. Whether tandem transplantation will prove more effective than current single high-dose therapy in appropriately selected patients remains to be determined.