Stem cell transplantation
Stem cell transplantation (or bone marrow transplantation) is offered to some patients with relapsed aggressive 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 you are fit enough to receive it and the aim of therapy is cure.
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.
There are two different types of stem cell transplant:
- Allogeneic, 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.
- Autologous, in which the patient's own stem cells, collected before the high-dose chemotherapy, are transplanted back into them.
Stem cell transplants in non-Hodgkin's lymphoma are usually autologous, although allogeneic transplants are becoming more common.
There are two main ways of sourcing the stem cells for transplantation, which require different medical techniques:
- 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
Find out more about stem cell transplantation
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.