Patients with advanced-stage follicular lymphoma (FL) are considered to be incurable and eventually
relapse after conventional chemotherapy. High-dose therapy (HDT) followed by autologous hematopoietic
stem cell transplantation (AHSCT) can unequivocally prolong the disease-free survival (DFS) but not overall
survival (OS) in the first complete remission and in a salvage setting. Recently, the incorporation of rituximab
and radioimmunoconjugates in HDT with AHSCT seems to be promising and widely accepted. Although
allogeneic hematopoietic stem cell transplantation (alloHSCT) consistently demonstrates longer DFS compared
with historical controls of HDT followed by AHSCT, this approach cannot be considered as a standard of care
due to its unacceptably high treatment-related mortality (TRM) and the lack of improving OS. With highly
encouraging results and less TRM, the role of nonmyeloablative hematopoietic stem cell transplantation
(NMHSCT), especially after AHSCT, needs to be validated in randomized controlled trials with a long-term
follow-up.

Keywords: Follicular lymphoma, Autologous hematopoietic stem cell transplantation, Allogeneic hematopoietic
stem cell transplantation, Nonmyeloablative hematopoietic stem cell transplantation