TRAINING and EDUCATION
Patient Education
UNDERSTANDING TRANSPLANT
IN LYMPHOMA
Hematopoietic cell transplantation (HCT), also called stem cell or bone marrow
transplantation, is a treatment option for patients with blood cancers such as leukemia,
multiple myeloma, or lymphoma. Together with radiation therapy or chemotherapy, HCT
is designed to increase the chance of eliminating the blood cancer and restore normal
blood cell production. Read on to learn more about how HCT is used to treat lymphoma.
This “Patient Education” tear sheet was produced in collaboration with the Lymphoma
Research Foundation (www.lymphoma.org).
What Is Hematopoietic Cell Transplantion?
Hematopoietic cell transplantation is a procedure that
replaces unhealthy blood-forming cells with healthy
cells. A hematopoietic or stem cell is an immature cell
in the bone marrow that can develop into mature blood
cells. These mature cells maintain a person’s blood cells,
replacing older or damaged cells with newer ones.
The ability to transplant stem cells allows physicians
to use higher doses of chemotherapy to treat the cancer
than the body would normally tolerate, because highdose chemotherapy can cause significant damage to
stem cells. If the chemotherapy is followed by an infusion of stem cells, these new stem cells can replace the
cells in the bone marrow that were destroyed during the
chemotherapy treatment.
Who Can Receive a Hematopoietic Cell
Transplant?
High-dose chemotherapy and HCT may place a great
strain on a patient’s body, so this is not an option for
everyone. This procedure is typically used for patients
with relapsed (disease returns after treatment), aggressive
lymphoma that is still sensitive to the effects of chemotherapy. The procedure does not work for patients with
tumors that are unresponsive to drugs.
When deciding if transplantation is a good option,
doctors will consider many factors, including the patient’s health status, age, medical history, cancer stage,
and response to previous therapy.
Types of Hematopoietic Cell
Transplants
Cut out and give to a patient
Autologous Hematopoietic Cell Transplantation
In autologous HCT (AHCT), hematopoietic cells are donated by the patient and collected and frozen before the
patient undergoes cancer treatment. After cancer treatment is administered and the cancer cells are believed
to be gone, the collected stem cells are reinfused back
into the patient.
Because a patient is receiving his or her own hematopoietic cells, an AHCT ensures a perfect match
between the patient and the transplanted cells, which
improves outcomes. Additionally, this procedure has
a lower risk of transmitting blood-borne infectious
diseases.
As these donated cells take hold (or engraft) in the
recipient, they begin to function as part of the immune
system and may attack the cancer cells. This is referred
to as graft-versus-tumor effect, which only occurs in
AlloHCT.
In some cases, the donor cells also attack the patient’s healthy cells. This is called graft-versus-host disease (GVHD). The more closely related the donor’s cells
are to the patient’s cells, the lower the risk of GVHD.
Reduced-Intensity Transplantation
Reduced-intensity transplantation (also called non-myeloablative or mini-allogeneic transplantation) is a type of
allogeneic transplantation. Unlike a standard allogeneic
transplant, this treatment uses lower doses of chemotherapy and/or radiation to prepare the patient for the
transplant. The reduced-intensity treatment kills some
of the cancer cells and bone marrow, and it suppresses
the patient’s immune system just enough to allow the
donor’s stem cells to settle into the bone marrow.
These types of transplants are used in patients with
adverse health conditions or older patients to avoid the
potential adverse effects of destroying bone marrow
during standard high-dose chemotherapy (with or without radiation).
Sources of Hematopoietic Cells
for Transplantation
Hematopoietic cells for transplantation can be obtained
from three sources: bone marrow, peripheral blood, and
umbilical cord blood.
Bone Marrow
Bone marrow, the tissue inside bones where blood cells
are generated, is a good source of hematopoietic cells,
and cells from the pelvis or hip bone are most often used
Allogeneic Hematopoietic Cell Transplantation
In allogeneic HCT (AlloHCT), the hematopoietic cell
donor is not the patient, but rather another person
who is genetically similar – often a sibling – though it
is possible for the donor to be unrelated to the patient.
After the patient has undergone chemotherapy and/or
radiation therapy, the donor’s hematopoietic cells are
infused into the patient.
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