Stem cell transplants
Stem cell transplants are sometimes used in the treatment of lymphoma. A stem cell transplant is a procedure that replaces damaged or destroyed stem cells in your bone marrow with healthy stem cells.
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What is a stem cell transplant?
Why are stem cell transplants used?
When might a stem cell transplant be used to treat lymphoma?
What are stem cells?
Every day, your body makes more than 300 billion new blood cells to replace cells that die off naturally.
Blood cells develop in your bone marrow from blood (haemopoietic) stem cells. Stem cells are undeveloped cells that can divide and mature into all the different types of blood cell your body needs.
There are three main types of blood cell:
- white blood cells (leucocytes), which fight infection
- red blood cells (erythrocytes), which carry oxygen around your body
- platelets (thrombocytes), which help your blood to clot if you have an injury.
What is a stem cell transplant?
A stem cell transplant is a procedure that replaces damaged or destroyed stem cells in your bone marrow with healthy stem cells.
There are two kinds of stem cell transplant:
- an autologous stem cell transplant uses your own stem cells
- an allogeneic stem cell transplant uses stem cells from a donor.
Other names for a stem cell transplant that you might hear include:
- a peripheral blood stem cell transplant, if the healthy stem cells are collected from the bloodstream
- a bone marrow transplant, if the healthy stem cells are collected from the bone marrow
- an autograft, using your own cells
- an allograft, using cells from a donor
- stem cell rescue or support.
Stem cell transplants are complicated, involving a number of stages. The process can take weeks or months. For detailed information on what stem cell transplants involve, see our separate pages on having a stem cell transplant, self (autologous) stem cell transplants and donor (allogeneic) stem cell transplants.
Why are stem cell transplants used?
Stem cells are dividing all the time to create the blood cells your body needs. They are very sensitive to the effects of chemotherapy, which kills cells that are actively dividing.
When chemotherapy damages or destroys the stem cells in your bone marrow, your body cannot produce all the blood cells it needs. This might lead to:
- a low white blood cell count, especially a type of white blood cell called a neutrophil (neutropenia)
- a low red blood cell count (anaemia)
- a low platelet count (thrombocytopenia).
Having low blood counts can sometimes mean making a change to your chemotherapy plan. For example, you might need to delay it, have a lower dose or have a shorter course than planned.
Cycles of chemotherapy usually include rest periods to let your bone marrow and blood counts can recover between treatments. However, some people need high doses of chemotherapy to treat their lymphoma. High doses of chemotherapy can be very effective at killing lymphoma cells but they can cause permanent damage to your stem cells.
A stem cell transplant allows you to be treated with a higher dose of chemotherapy than you would usually be able to have because it replaces the stem cells damaged by the chemotherapy. This allows your bone marrow to recover and make all the new blood cells that your body needs. Even after a stem cell transplant, it can take your bone marrow several weeks to recover, although it can be more or less than this. It can take much longer – several months or more – for you to fully recover.
In an allogeneic stem cell transplant, as well as helping your bone marrow recover, the donor stem cells develop into new immune cells that recognise your lymphoma cells as foreign or ‘non-self’. This can help your body fight the lymphoma.
When might a stem cell transplant be used to treat lymphoma?
Stem cell transplants are an intensive form of treatment and you have to be well enough to have one.
Whether or not you need a stem cell transplant depends on lots of different factors, including the type of lymphoma you have, how your lymphoma responds to treatment and how well you are.
In general, a stem cell transplant might be used if:
- your medical team thinks your lymphoma is very likely to come back (relapse) after treatment
- your lymphoma doesn’t respond to treatment (refractory)
- your lymphoma has relapsed after treatment.
In these circumstances, a stem cell transplant might increase your chance of having a longer-lasting remission from lymphoma.
My medical team started talking about a different chemotherapy regimen and an autologous stem cell transplant, using my own stem cells. I didn’t know anything about stem cell transplants and struggled to get my head around it.
Read Faye’s story.
Listen to our podcast on stem cell transplants
In this podcast, John Murray, Advanced Practitioner in Bone Marrow Transplant, and Angie Leather, Lead Nurse for Transplant and Haematology, talk about the role of stem cell transplants, when they are used and the important differences between autologous (self) and allogeneic (donor) stem cell transplants. This podcast includes discussions around this often very difficult subject, and contains information on side effects and treatment outcomes that may be potentially distressing.
Trusted Information
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