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High-dose chemotherapy and hematopoietic SCT in the management of natural killer-cell malignancies
Bone Marrow Transplantation, 10/01/09
Kwong Y–L – Autologous HSCT may not be necessary for good–risk patients in CR. Whether poor risk patients will have improved outcome with autologous HSCT remains to be defined. The role of allogeneic HSCT requires more rigorous future studies.
Y-L Kwong, 10/01/09
| Natural killer cell malignancies are classified as extranodal NK/T cell lymphoma, nasal type, and aggressive NK cell leukemia in the current WHO classification. It is a disease predominantly found in Asian and South American populations, although occasional cases have now been reported from Western patients. Although it is traditionally viewed as an aggressive lymphoma, early stage disease in fact has a favorably prognosis. Haematopoietic stem cell transplantation therefore is not indicated for such patients in first complete remission. Even for patients with localized relapse, salvage chemotherapy and radiotherapy is also effective. However, for patients with advanced disease (stage III, IV) and the leukemic form of the disease, treatment results are unsatisfactory. Unfortunately, autologous haematopoietic stem cell transplantation has not been shown to be beneficial to these patients. Allogeneic haematopoietic stem cell transplantation may be the best option. The number of patients treated by this modality is small, and its efficacy remains to be defined by prospective clinical trials. |
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