You might have a bone marrow transplant as part of your treatment for non Hodgkin lymphoma (NHL). Find out more about this treatment.
What it is
A bone marrow transplant (BMT) allows you to have very high doses of chemotherapy. Sometimes you have this with radiotherapy. It aims to cure your cancer. Because you can have higher doses of treatment, there may be a greater chance of curing NHL than with standard chemotherapy.
What bone marrow is
Bone marrow is the spongy substance inside your bones. It makes all your blood cells.
Collecting bone marrow
Before you have high dose chemotherapy, doctors take out some of your bone marrow and freeze it. This is called a bone marrow harvest. They then store the bone marrow.
High dose treatment
You have high doses of chemotherapy drugs and radiotherapy to kill off any remaining NHL cells. But the treatment also damages your bone marrow. This means you can't make any new blood cells.
Returning the bone marrow
After the high dose chemotherapy, the nurse thaws your bone marrow. They give it back to you through a drip (transfusion). Then you can make the blood cells you need again. This is called an autologous bone marrow transplant.
Why you have it
Your doctor might suggest a bone marrow transplant if your NHL:
- is in remission but is likely to come back
- is in a second remission
- has not responded to other treatment
These days, more people have stem cell transplants than bone marrow transplants. Using stem cells means you don't need an anaesthetic to collect the cells. And your blood counts might recover more quickly after the high dose chemotherapy. But you might have a bone marrow transplant if collecting stem cells is difficult.
Using bone marrow from a donor
You might have bone marrow donated by another person. This is usually a brother or sister if their bone marrow matches yours. A transplant using bone marrow from another person is called an allogeneic transplant.
You sometimes have an allogenic transplant if your lymphoma comes back after a transplant that used your own stem cells or bone marrow. But allogeneic transplants have more side effects and complications, so they are not suitable for everyone.
Collecting your bone marrow
Collecting bone marrow is called a bone marrow harvest. Patients and bone marrow donors have the same procedure to collect bone marrow.
You have a general anaesthetic.
The doctor puts a needle through the skin into your hip bone (pelvis) to remove the bone marrow. The bone marrow is sucked out through the needle into a syringe.
To get enough marrow, the doctor usually has to put the needle into several different parts of the pelvis. Occasionally, the doctor uses the breast bone (sternum) as well. The doctor removes about two pints of bone marrow and freezes it.
When you wake up, you have up to six puncture sites covered with sticking plasters. You feel very sore and bruised at first. The soreness can last for up to a week. Your doctor gives you some painkillers to take.
You usually have to stay in hospital overnight after a bone marrow harvest. This is to make sure you have recovered from the anaesthetic. You might also need a blood transfusion afterwards.
Taking part in a clinical trial helps researchers improve treatment for non Hodgkin lymphoma.