Transplantation outcome in primary mediastinal large B-cell lymphoma

Primary mediastinal B-cell lymphoma (PMBL) is a distinct subtype of diffuse large B-cell lymphoma that has a high response rate to dose-intense chemotherapy regimens and the standard CHOP regimen, especially when combined with rituximab. High-dose chemotherapy and autologous stem cell transplantation (ASCT) has been used for both consolidation of first remission and treatment of relapsed or refractory PMBL. In general, the favorable outcome after first line immunochemotherapy obviates the need for stem cell transplant in first remission. Limited data from small uncontrolled studies make it difficult to draw firm conclusions about the efficacy of salvage chemotherapy and ASCT for relapsed or refractory PMBL, but outcomes are probably worse than for patients with relapsed/refractory diffuse large B-cell lymphoma.