Hodgkin lymphoma (HL) is a pathologically and clinically heterogeneous hematologic malignancy. In the United States, an estimated 185,000 people are currently living with this disease, and it accounted for more than 9,000 new cases of cancer in 2015. Chemotherapy and radiation provide long-term benefit to the majority of patients with HL; however, some patients will eventually relapse.
Autologous hematopoietic stem cell transplantation (aHSCT) is a well-established treatment for hematologic malignancies such as multiple myeloma (MM) and non-Hodgkin lymphoma (NHL). Various changes in the field over the past decade, including the frequent use of tandem aHSCT in MM, the advent of novel therapies for the treatment of MM and NHL, plus the addition of new stem cell mobilization techniques, have led to the need to reassess current stem cell mobilization strategies.
Hematopoietic cell transplantation has become a cornerstone in the management of patients with lymphoma. The use of autologous transplant in Hodgkin’s and non-Hodgkin’s lymphoma has significantly improved the survivals of patients with relapsed disease.
Although myelofibrosis (MF) is the least common of the myeloproliferative neoplasms, it is the most lethal with a median survival of only 3-5 years. Cytopenias and leukemic transformation are the major causes of death. For many years palliation of symptoms with alkylating agents or hydroxyurea was the only therapy available and this had little or no effect on the survival of patients with MF.
Aplastic anemia (AA), the myelodysplastic syndromes (MDS), and paroxysmal nocturnal hemoglobinuria (PNH) are rare diseases that all result in bone marrow failure—the ineffective formation of circulating blood cells—leading to anemia, bleeding, infection, and death in many cases, even with modern therapies. Once thought of as distinct, these three diseases are now believed to be linked by similar pathophysiologic pathways. Of the three bone marrow failure diseases, MDS currently has the largest number of therapeutic drugs available, although none of them is curative. Much of the current confusion and controversy in MDS treatment stems from the lack of consensus on which therapies to use in which patients, and what realistic outcomes might be.
During the last two decades, the treatment of multiple myeloma (MM) has produced significant improvements in overall survival and quality of life. This can be attributed to the use of autologous stem cell transplantation, novel drugs in combination with old drugs, bisphosphonates, improved supportive care, and, importantly, dissemination of knowledge about the disease and treatments through multiple societies and medical centers.