You might have a stem cell transplant as part of your treatment for non Hodgkin lymphoma (NHL). Find out more about this treatment.
What it is
A stem cell transplant allows you to have very high doses of chemotherapy. Sometimes you have this with radiotherapy. It aims to cure your cancer. High dose treatment with a stem cell transplant can have a better chance of curing some types of NHL, or controlling them for a longer time, than standard chemotherapy.
What stem cells are
Bone marrow is the spongy substance inside your bones. It contains stem cells. Stem cells develop into red blood cells, white blood cells and platelets.
Collecting stem cells
Before you have high dose chemotherapy, a specialist nurse takes the stem cells from your blood. This is called a stem cell collection or stem cell harvest. They freeze and store the stem cells.
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, including the stem cells. This means you can't make any new blood cells.
Returning the stem cells
After the high dose chemotherapy, the nurse gives you back your stored stem cells through a drip (transfusion). Then you can make the blood cells you need again. This is called an autologous stem cell transplant.
Why you have it
Your doctor might suggest a stem cell transplant if your NHL:
- is in remission but is likely to come back
- is in a second remission
- has not responded to other treatment
Using stem cells from a donor
It is possible to have stem cells donated by a brother or sister. A transplant using donated stem cells is called an allogeneic stem cell transplant. Your brother or sister would have to have a blood test first to make sure their bone marrow is a match with yours.
Sometimes you could have stem cells from someone who is not related to you, but who has matching bone marrow. This is called a matched unrelated donor transplant. It is sometimes used if your lymphoma comes back after a transplant using your own stem cells. But allogeneic transplants have more side effects and complications, and are not suitable for everyone.
Collecting stem cells
The nurse might collect your stem cells after you have had a course of chemotherapy. This is because some of the stem cells move out of the bone marrow and into the blood at this time.
If you don't have enough stem cells, you might need to have injections of a drug called G-CSF. If stem cells are being collected from a donor, your donor will need to have this drug. It makes stem cells spill out from the bone marrow and into the blood.
You have the G-CSF injections for up to 10 days. You have blood tests to check the level of stem cells in your bloodstream. When there are enough, your stem cells are collected.
The nurse often needs to collect your cells for 2 or sometimes 3 days in a row to get enough. Collecting the stem cells takes 3 or 4 hours each time.
You lie down on a couch. The nurse puts a drip into each of your arms and attaches the drip to a machine. Your blood passes out of one drip, through the machine and back into your body through the other drip. The machine filters the stem cells out of your blood.
The stem cells are frozen until you are ready to have them back. You have them back after you finish your high dose chemotherapy treatment.
Taking part in a clinical trial helps researchers improve treatment for non Hodgkin lymphoma.