High-dose treatment with autologous stem cell transplantation versus sequential chemotherapy: the GELA experience

Autologous stem-cell transplantation (ASCT) has permitted to deliver high-d ose therapy (HDT). In aggressive lymphomas, the GELA group conducted prospe ctive and retrospective studies comparing HDT + ASCT to conventional sequen tial chemotherapy. In relapsing patients and in partial remission, retrospe ctive studies showed a survival advantage for HDT + ASCT over sequential ch emotherapy. In complete response, advantage for HDT + ASCT was demonstrated in a prospective trial only for patients with high intermediate or high ri sk in the IPI score. The attainment of a maximal reduction of the tumoral m ass before going HDT is very important either in first line or in relapsing patients.