EBMT 2025 | Optimizing conditioning regimens prior to autoSCT or alloSCT for lymphoma

So I was basically discussing conditioning regimens in lymphoma, so not in every single hematological malignancy. And basically what I want to say is first of all, lymphomas, if we consider stem cell transplantation, this is the second major indication for auto transplant as opposed to acute leukemias that are the major indication for allogeneic stem cell transplantation. We only have a few patients that are being treated with allogeneic stem cell transplant. 

The second topic is that stem cell transplantation is being reviewed in the lymphoma setting just because of the advent of new treatment strategies including CAR T-cells. 

Third, most of our knowledge regarding conditioning strategies in the lymphomas comes from retrospective analyses, so not the best type of information that we would like to have. If we talk about conditioning regimens in the autologous setting, there have been several strategies to increase the intensity of the conditioning regimen that have not worked out because they might be more effective but they are associated with more toxicity. For Hodgkin lymphoma, and we have an oral presentation in this meeting, BEAM is the most frequently used and the most effective conditioning regimen. 

If we move to the allo setting in most of our lymphoma patients we are using reduced intensity conditioning protocols because they are associated with a lower non-relapse mortality and they allow more lymphoma patients to eventually be candidates for an auto transplant, to receive the autologous stem cell transplantation process. 

Thiotepa conditioning regimens are gaining more and more interest because thiotepa is really a very effective drug included in the conditioning regimen and it’s associated with a really mild toxicity profile.

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