TY - CHAP M1 - Book, Section TI - Autologous Hematopoietic Progenitor-Cell Transplantation A1 - Saini, Neeraj A1 - Nieto, Yago A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. A2 - Rieber, Alyssa G. PY - 2022 T2 - The MD Anderson Manual of Medical Oncology, 4e AB - KEY CONCEPTSThe use of autologous hematopoietic progenitor-cell transplant (AHPCT) overcomes myelotoxicity of high-dose chemotherapy (HDC). Therefore, drugs with a markedly myelosuppressive side effect profile and a steep dose-response effect are preferred. The most common nonhematologic regimen-related toxicity (RRT) is oropharyngeal mucositis, which is rarely life threatening. The most common among the potentially severe extramedullary RRT are interstitial pneumonitis and veno-occlusive disease of the liver.HDC with AHPCT has been the standard of care for chemosensitive, relapsed diffuse large B-cell lymphoma (DLBCL) for the last three decades. However, the results remain suboptimal in patients whose disease relapses less than one year after completion of frontline chemoimmunotherapy (eg, R-CHOP).In follicular lymphoma, HDC with AHPCT should be considered for high-risk relapses occurring within two years of completing frontline therapy (POD24) or second or more advanced relapses.Management of relapsed or primary refractory Hodgkin lymphoma in patients should be a salvage strategy using one or more lines of therapy, including regimens such as bendamustine/brentuximab vedotin or ifosfamide/carboplatin/etoposide aiming at a positron emission tomography–negative remission before AHPCT. Patients with a high-risk for disease relapse should be considered for post-AHPCT maintenance with brentuximab vedotin.Modern treatment of newly diagnosed myeloma should include induction with a proteasome inhibitor and an immunomodulatory drug (eg, bortezomib/lenalidomide/dexamethasone [VRD]) followed by melphalan-based HDC and AHCPT, and consolidation and/or maintenance with drugs like lenalidomide, with the goal of achieving a minimal residual disease-negative remission.Tandem cycles of carboplatin-containing HDC with AHPCT should be considered for any patient with a germ-cell tumor in the second or later relapse. Their role in the first relapse is still undetermined. SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1190833866 ER -