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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more| .
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For some people, treatment will completely cure their lymphoma. Other people, however, may find that their lymphoma comes back. If this happens, it may still be possible to give treatment in order to provide a further remission.
Even if this is not possible, treatment can be given to shrink the lymph nodes and control the disease to keep you well, often for long periods. Such treatment might be chemotherapy|, radiotherapy|, a combination of both, or a stem cell transplant.
Some people may be offered treatment with very high doses of chemotherapy, sometimes combined with radiotherapy.
Your doctor will discuss with you whether this treatment is appropriate and possible in your case. High-dose chemotherapy is a very intensive treatment that needs to be given by doctors with experience of managing the side effects.
Before high-dose treatment can be considered, stem cells (the basic blood cells from which other cells develop) must be collected from your body at a time when you are well. This is called a stem cell harvest. The stem cells are then frozen and kept in storage until you have high-dose treatment.
Harvesting the stem cells involves giving you several injections of growth factors to increase the number of stem cells in your blood. The stem cells are then collected by a process in which blood is removed through a needle in your arm. The blood is then passed through a machine called a cell separator. The cells are separated out as the rest of your blood flows back in to you through another needle. Alternatively, stem cells can be collected from your bone marrow. For this, you will need to have a general anaesthetic.
High doses of chemotherapy destroy the bone marrow, where our blood cells are usually made. After the high-dose chemotherapy has been given, the stem cells are thawed and given back into your blood through a drip. The stem cells make their way to your bone marrow where they start to produce blood cells. This can take a few weeks. You will be very prone to infection at this time so you are likely to need to stay in hospital.
In most cases, your own stem cells are collected and then given back to you after the high-dose chemotherapy. This is called an autologous transplant.
Some people may be given stem cells from another person (a donor) rather than using their own cells and this is called an allogeneic transplant.
Our section stem cell and bone marrow transplants| gives more information on this treatment.
Over time, some low-grade (indolent) lymphomas can become more aggressive (high-grade). This happens in about a third of all low-grade NHL and depends upon the type. It can take many years before an indolent lymphoma becomes high-grade. If indolent lymphoma transforms, it will need to be treated as a high-grade lymphoma.
Sometimes it is possible for both low-grade and high-grade NHL to be diagnosed in the same person, at the same time. If this happens the NHL is usually treated as high-grade.
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If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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