What is a stem cell or bone marrow transplant?

You might have a stem cell or bone marrow transplant as part of your treatment for non-Hodgkin lymphoma (NHL). 

A transplant allows you to have high doses of chemotherapy and other treatments. The stem cells are collected from the bloodstream or the bone marrow.

What are stem cells?

Stem cells are very early cells made in the bone marrow. Bone marrow is a spongy material that fills the bones.

Diagram of bone marrow

These stem cells develop into red blood cells, white blood cells and platelets. 

Diagram of three different types of blood cell

Red blood cells contain haemoglobin which carries oxygen around the body. White blood cells are part of your immune system and help to fight infection. Platelets help to clot the blood to prevent bleeding. 

Diagram of bone marrow

These stem cells develop into red blood cells, white blood cells and platelets. 

Diagram of three different types of blood cell

How transplants work

You have a stem cell transplant after very high doses of chemotherapy. You might have targeted drugs with the chemotherapy. You may also have radiotherapy to your whole body. This is called total body irradiation or TBI.

The radiotherapy and chemotherapy has a good chance of killing the lymphoma cells. But it also kills the stem cells in your bone marrow. So your team either collects:

  • your stem cells
  • or a donor's stem cells 

After the treatment you have the stem cells into your bloodstream through a drip. The cells find their way back to your bone marrow where they start making blood cells again and your bone marrow slowly recovers.

Photograph showing a stem cell transplant

What is the difference between a stem cell and bone marrow transplant?

The main difference is whether stem cells are collected from the bloodstream or bone marrow. A stem cell transplant uses stem cells from your bloodstream, or a donor’s bloodstream. This is also called a peripheral blood stem cell transplant. A bone marrow transplant uses stem cells from your bone marrow, or a donor’s bone marrow.

Stem cell transplants are the most common type of transplant. Bone marrow transplants are not used as much.  This is because:

  • it’s easier to collect stem cells from the bloodstream than bone marrow
  • your team can usually collect more cells from the bloodstream
  • blood counts tend to recover quicker following a stem cell transplant

You might have a bone marrow transplant if collecting stem cells has been difficult in your situation.

Why you might have a transplant

The aim of NHL treatment is usually to put it into remission. Remission means there is no sign of lymphoma.

Your doctor might suggest a transplant if your NHL:

  • is in remission but is likely to come back 
  • is in a second remission 
  • has not responded to other treatments 

High dose chemotherapy and a transplant aims to cure some types of NHL. Or it might control the lymphoma for longer if a cure is not possible.

Types of transplant

Depending on your situation, you might have a transplant using:

  • your own stem cells
  • or stem cells from another person (a donor) 
  • ESMO Clinical Practice Guidelines
    Accessed December, 2020

  • Non Hodgkin's lymphoma : diagnosis and management (NG52)
    National Institute for Health and Care Excellence (NICE), 2016

  • Cancer and its Management 

    D Hochhauser and J Tobias

    Wiley-blackwell, 2010

  • Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American society for Blood and Marrow Transplantation 
    N Majhail and others 
    Biology of Blood and Marrow Transplantation, 2015. Volume 21, Issue11, pages 1863–1869

  • Hematopoietic stem cell tranplantation in Europe 2014: more than 40 000 transplants annually
    JR Passweg and others  
    Bone Marrow Transplant, 2016. Volume 51, Issue 6, pages 786-792

Last reviewed: 
30 Dec 2020
Next review due: 
30 Dec 2023

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