High dose treatment with stem cell support for non-Hodgkin lymphoma

Stem cells are early blood cells. They make all the other types of blood cells you need. Some people with NHL may have a stem cell transplant after chemotherapy. This helps their body make new blood cells.

Most people won’t need a stem cell transplant. But it may be used to treat types of NHL that don’t respond well to standard chemotherapy. It’s also sometimes used to treat NHL that has come back after treatment.

First, you are given chemotherapy to get rid of the lymphoma. You are then given your own stem cells, or stem cells from a donor, as an infusion into your bloodstream. The stem cells go to your bone marrow where, after a few days, they will begin making new blood cells. Until your blood cell numbers have recovered, you will be at risk of infection and will need to stay in hospital.

This is an intensive treatment. You will go to a specialist hospital and usually be an inpatient for two weeks or more. Your lymphoma specialist can discuss with you whether or not a stem cell transplant is necessary.

Stem cell transplants for non-Hodgkin lymphoma

Stem cells are early blood cells, which can make all the different types of blood cell you need. There are two types of stem cell transplant. One uses your own stem cells. The other uses stem cells from someone else (a donor).

Most people who have NHL will not need a stem cell transplant. But it may be used to treat types of NHL that don’t respond well to the most commonly used chemotherapy treatments. It is also sometimes used to treat people who have NHL that has come back (relapsed) after treatment.

A stem cell transplant is an intensive treatment. It is only suitable for people who are fit enough to cope with the side effects. If your doctor recommends it as part of your treatment, they will discuss the possible benefits and disadvantages with you.

Because stem cell transplants are complicated treatments and carry some risk, they are done in specialist hospitals. This means you may have to be treated in a hospital some distance from your home.

Research is being done to find the best ways to use stem cell transplants to treat NHL. Your specialist may talk to you about having a stem cell transplant as part of a research trial.


Having a stem cell transplant

A stem cell transplant works best if you are in remission at the time that you have it. For this reason, you will have chemotherapy to put the lymphoma into remission before having a stem cell transplant.

Once you are in remission, stem cells are collected from either your own blood or the donor’s blood and they are stored. This is done as an outpatient. You will then be admitted to hospital, usually a few weeks later, to have more chemotherapy. This is called conditioning treatment. Sometimes radiotherapy is also given as part of conditioning. The aim is to remove any remaining lymphoma cells and to prepare your bone marrow for the transplant. Bone marrow is where blood cells are made.

A day or two after this, you are given the stem cells into your blood through a drip. The stem cells travel to your bone marrow. After a few weeks, your bone marrow starts to make blood cells again. Until your bone marrow recovers, you are at a high risk of getting an infection and will need to stay in hospital.


High-dose treatment with stem cell support (autologous stem cell transplant)

This involves being given your own stem cells. The main benefit is that it allows you to have more intensive doses of chemotherapy to treat the lymphoma. Most people having an autologous stem cell transplant need to be in hospital for 3 to 5 weeks. Then they take 3 to 6 months at home to fully recover.


Donor (allogeneic) stem cell transplant

In this type of transplant, you are given stem cells from another person (a donor). The donor’s stem cells help your bone marrow recover from chemotherapy and give you a new immune system that can fight any remaining lymphoma.

This kind of transplant can have more risks than an autologous transplant. It may be used for people with lymphomas that are difficult to treat using less intensive therapies.

We have more information about high-dose treatment with stem cell support, and donor stem cell transplants, which explain these treatments in detail.