nmdp logo

Non-Hodgkin lymphoma (NHL)

Transplant advances and outcomes

Non-Hodgkin lymphomas (NHL) are a highly heterogeneous group of lymphoproliferative disorders originating in B lymphocytes, T lymphocytes or natural killer (NK) cells. In the United States, B-cell NHL represents 80-85% of cases; T-cell NHL, 15-20%; and NK NHL is rare. Most hematopoietic cell transplantation (HCT) performed for NHL is autologous, but in some cases, physicians may perform allogeneic HCT for particularly high-risk relapsed or refractory disease. [1, 2]

Recommended timing for transplant consultation

Follicular (FL)

  • Transformation to diffuse large B-cell lymphoma
  • Poor response to initial treatment
  • Initial remission duration <24 months
  • At relapse (CAR or alloHCT can be offered to patients with multiple relapsed FL)

Diffuse Large B-Cell

  • Primary CNS lymphoma at diagnosis PIF or first relapse
  • Primary induction failure, including residual PET avid disease
  • First relapse
  • CR2 or subsequent remission
  • Double or triple hit (MYC and BCL-2 and/or BCL-6) – at diagnosis

High Grade B-Cell

  • MYC and BCL-2 and/or BCL-6 rearrangements
  • Primary induction failure
  • CR1
  • First relapse
  • CR2 or subsequent remission

Mantle Cell

  • At diagnosis
  • At relapse
  • Bruton’s tyrosine kinase (BTK) intolerant or resistant disease

Mature T-cell and NK Cell Lymphoma

  • At diagnosis or CR1
  • At relapse

Other High-Risk Lymphomas

  • At diagnosis

References

  1. National Comprehensive Cancer Network. B Cell Lymphomas. (Version 5.2022). Access
  2. Dreyling M, Ferrero S, Hermine O. How to manage mantle cell lymphoma. Leukemia. 2014; 28(11): 2117-2130. Access
  3. NMDP and ASTCT Recommended Timing for Transplant Consultation. Download PDF 
  4. Zhang J., Hu Y., Yang J. et al. Non-viral, specifically targeted CAR-T cells achieve high safety and efficacy in B-NHL. Nature. 2022; 609: 369–374. Access