Stem cell transplantation
Stem cell transplantation (or bone marrow transplantation) is offered to some patients with relapsed indolent non-Hodgkin's lymphoma. You may be offered this treatment if your doctor thinks it is the best way forward. Generally it is offered if chemotherapy has not been successful or is not appropriate for you.
Stem cells are the immature blood cells that form in bone marrow. They develop into the mature blood cells - red blood cells, white blood cells and platelets.
Transplantation involves the use of very high-dose chemotherapy (sometimes with radiotherapy) that destroys the bone marrow. The destroyed bone marrow must then be restored with the transplanted stem cells.
ASCT (autologous stem cell transplant) is a transplant where the patient's own stem cells are collected before the high-dose chemotherapy, and are later transplanted back. This type of transplant is the most common type.
(Another transplant option is an allogeneic transplant, in which the stem cells come from another person - a donor. The donor may be a relative, ideally a twin. Otherwise, they could be a brother or sister. Another unrelated, but matched, person may also donate marrow.)
There are two main types of transplantation, depending on the source of the stem cells:
- Peripheral blood stem cell transplant, where the cells are taken from the circulating blood
- Bone marrow transplant, in which the bone marrow is used as the source of the cells
After the high-dose chemotherapy has destroyed the marrow and before the marrow has recovered, the main risk is infection. This risk period lasts for a few weeks, during which time the patient stays in hospital. Antibiotics and top-up blood transfusions may be given.
Stem cell transplantation may be used in patients whose indolent non-Hodgkin's lymphoma has relapsed as an aggressive form of the disease. It increases the chances of entering remission.