Autologous stem cell transplantation for follicular lymphoma is of most benefit early in the disease course and can result in durable remissions, irrespective of prior rituximab exposure

<jats:title>Summary</jats:title><jats:p>The role of autologous stem cell transplantation (<jats:styled-content style="fixed-case">ASCT</jats:styled-content>) and the optimal timing of such transplants in patients with follicular lymphoma (<jats:styled-content style="fixed-case">FL</jats:styled-content>) remains contentious. We present a single‐centre experience documenting the outcomes of 70 <jats:styled-content style="fixed-case">FL</jats:styled-content> patients who underwent <jats:styled-content style="fixed-case">BEAM</jats:styled-content> (carmustine, cytarabine, etopside, melphalan)‐conditioned <jats:styled-content style="fixed-case">ASCT</jats:styled-content> between 1988 and 2009. With a median follow‐up of 6·8 years (0·1–19·2), the 7‐year overall survival (OS) and progression‐free survival (PFS) from the date of <jats:styled-content style="fixed-case">ASCT</jats:styled-content> was 76% and 60%, respectively. A significant difference in <jats:styled-content style="fixed-case">OS</jats:styled-content> was found when comparing the patients transplanted in first or second remission <jats:italic>versus</jats:italic> those transplanted in later remissions (<jats:italic>P</jats:italic> = 0·02) and this significance was maintained when <jats:styled-content style="fixed-case">OS</jats:styled-content> was calculated from the date of diagnosis (<jats:italic>P</jats:italic> = 0·03). There was a plateau on the <jats:styled-content style="fixed-case">PFS</jats:styled-content> curves for patients transplanted in either first or second remissions after 9·3 and 6·4 years respectively, suggesting that these groups may never relapse. No differences were seen in OS or PFS in those treated with rituximab prior to transplant <jats:italic>versus</jats:italic> those who were not. Our data shows that <jats:styled-content style="fixed-case">BEAM ASCT</jats:styled-content> can be a highly effective treatment in patients with <jats:styled-content style="fixed-case">FL</jats:styled-content> early in the disease course, and that a proportion of patients experience prolonged disease‐free survival and may be cured.</jats:p>