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Stem cell transplantation for non-Hodgkin lymphoma

What is a stem cell transplantation?

A stem cell transplant (also called Hematopoietic Progenitor Cell Transplantation) infuses healthy blood-forming stem cells into the body. Stem cells can be collected from the bone marrow, circulating (peripheral) blood, and umbilical cord blood.

There are two main types of stem cell transplants:

  • Autologous stem cell transplant: In this type of stem cell transplant, stem cells are collected from the patient themselves. The stem cells are removed from the patient's blood, harvested, frozen and stored until needed, then given back to the patient after he/she has received high dose chemotherapy and/or radiation therapy to destroy the cancer cells.
  • Allogeneic stem cell transplant: In this type of transplant, stem cells are taken from a matching donor. Donors may include a relative/family member (e.g., sibling), unrelated individual, or saved umbilical cord blood. To determine if a donor’s stem cells are the right match, the patient undergoes a human leukocyte antigens (HLA) test. In an HLA test, we compare the patient’s blood and tissue type with blood samples from the donor.

An advantage of an allogeneic transplant is that the stem cells come from a healthy donor with no malignant cells. However, since it can be difficult to find a matching donor, an autologous transplant is usually more common.

Stem cell transplantation for non-Hodgkin lymphoma

Before a stem cell transplant for non-Hodgkin lymphoma, you will undergo a conditioning regimen, which involves intensive treatment, such as high-dose chemotherapy, to destroy as many cancer cells as possible. Following this preparative regime, you will receive the stem cells intravenously (similar to a blood transfusion). The procedure takes about an hour. After entering the bloodstream, the stem cells travel to the bone marrow and begin to produce healthy new blood cells in a process known as engraftment.

Sometimes, the high doses of chemotherapy or radiation you receive before the stem cell transplant  causes side effects, such as infection. An allogeneic stem cell transplant poses the risk of graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient’s tissues. Your doctor may prescribe certain drugs to reduce the risk of infection or GVHD.

Helping you manage side effects after a transplant

Recovery from stem cell transplantation can take several months. You’ll need support from multiple areas to help you manage side effects and maintain your quality of life.

The following are examples of how your care team will support you during this time:

  • Your nutritionist will develop a personalized meal plan to fortify your body after the transplant.
  • Your naturopathic clinician will recommend natural therapies to help minimize side effects like peripheral neuropathy and fatigue.
  • Your pain management practitioner will use pain management methods to help control pain and alleviate discomfort.
  • Your mind-body therapist will provide counseling and stress management techniques to help you relax.
  • Your rehabilitation therapist will create an individual exercise program to help you stay active and independent.
  • Your spiritual counselor will help nurture your spiritual well-being.
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