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Stem cell transplant for non-Hodgkin lymphoma
A stem cell transplant is sometimes used to treat non-Hodgkin lymphoma (NHL). It is used to replace stem cells when stem cells or bone marrow are damaged. A stem cell transplant is a very risky and complex procedure that must be done in a specialized transplant centre or hospital.
Stem cells are found in the bone marrow, the bloodstream and umbilical cords. They are basic cells that develop into different types of cells that have different jobs. All blood cells develop from blood stem cells.
A stem cell transplant uses high-dose chemotherapy or total body radiation therapy to kill all of the cells in the bone marrow. This includes both healthy cells and the lymphoma cells. After high-dose chemotherapy, healthy stem cells are given to replace the ones in the bone marrow that were destroyed.
You may be offered a stem cell transplant to treat NHL if:
- the high-risk NHL is in remission after treatment
- the NHL comes back after treatment (called relapsed NHL)
- the NHL is refractory (means that treatments stop working)
Types of transplants used for NHL
The following types of stem cell transplant may be used with NHL.
In this type of transplant, the stem cells are taken from your own bone marrow or blood.
An autologous stem cell transplant is done most often for NHL. It may not be possible to do this type of transplant for some types of NHL if they have spread to the bone marrow or blood because it can be difficult to get enough normal stem cells.
In this type of transplant, the stem cells are taken from one person (the donor) and are given to another person (the recipient). The donor may be a relative or may be unrelated to the recipient. The donor and recipient are matched through a process called human leukocyte antigen (HLA) typing.
Not everyone can have an allogeneic transplant because they need to match with a donor. It is the type of stem cell transplant that may be done if the NHL has spread to the bone marrow or blood.
Some people who are older or have other medical conditions can’t handle the side effects from the high doses of chemotherapy that are given before stem cell transplants. They may be offered a reduced-intensity transplant (also called mini-transplant or non-myeloablative transplant). It uses lower doses of chemotherapy before the transplant. A reduced-intensity transplant may also be the preferred type of transplant for certain types of NHL.
Side effects can happen with any type of treatment for NHL, but everyone’s experience is different.
Side effects can develop any time during, immediately after or a few days or weeks after a stem cell transplant. Sometimes late side effects develop months or years after a stem cell transplant. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of stem cell transplant will depend mainly on the type of chemotherapy drugs or combination of drugs given, if radiation therapy was given, the type of transplant you have and your overall health. Common side effects of a stem cell transplant include:
The side effects of a stem cell transplant can be very serious or even life-threatening. The healthcare team watches people receiving a stem cell transplant very closely. They take measures to prevent and quickly deal with any side effects. Tell your healthcare team if you have these side effects or others you think might be from your stem cell transplant. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Questions to ask about stem cell transplant
A decrease in or the disappearance of signs and symptoms of a disease (such as cancer).
Complete remission means the disappearance of all signs or symptoms. Partial remission means a decrease in or disappearance of some, but not all, signs and symptoms. Spontaneous remission is an unexpected improvement that occurs with little or no treatment.
A protein found on the surface of all cells, including white blood cells (leukocytes) and platelets, that plays a role in the immune system’s response to foreign substances.
HLAs are typed in a similar way to red blood cells (A, B, O or AB). HLA typing is done before stem cell or organ transplant to make sure that the donor’s tissues match the recipient’s.
Also called human leukocyte-associated antigen or human lymphocyte antigen.