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Stem Cell Transplantation

Stem cell transplantation is a procedure in which patients receive healthy stem cells to replace their own stem cells that have been destroyed by cancer or cancer treatments. The goal of stem cell transplantation is to help the body start a new supply of blood cells after the patient gets high-dose chemotherapy.

Stem cell transplantation is higher risk than chemotherapy alone or in combination with radiation therapy. The effectiveness of therapies for newly diagnosed Hodgkin lymphoma (HL) patients has reduced the need for stem cell transplantation and it isn't recommended for initial treatment of HL patients. However, it may provide a cure for patients with disease that is relapsed (returned after treatment) or refractory (does not respond to treatment).

The two types of stem cell transplantation are:

  • Autologous stem cell transplantation is a treatment that uses the patients own stem cells. Autologous transplants are generally done in the hospital. With an autologous transplant
    • The patient’s own stem cells collected from his/her blood or marrow are frozen and stored. 
    • The patient is then given high-dose chemotherapy and sometimes radiation therapy to kill the lymphoma cells in his or her body. This also kills normal stem cells in the marrow.
    • The patient’s stored stem cells are returned to their body through an intravenous (IV) or central line. 
    • The donor stem cells go from the patient’s blood to the marrow and help start a new supply of red blood cells, white blood cells and platelets.

Autologous stem cell transplantation with high-dose chemotherapy remains the standard therapy for relapsed and refractory Hodgkin lymphoma. Brentuximab vedotin is also sometimes given to treat patients before transplant or administered in select patients as maintenance treatment after autologous stem cell transplantation.

  • Allogeneic stem cell transplantation is a treatment that uses stem cells from a donor. The donor may be a relative or an unrelated person with stem cells that "match" the patient's. Allogeneic transplants are done in the hospital. With an allogeneic transplant
    •  Stem cells collected from a donor and are frozen and stored.
    • The patient is given high-dose chemotherapy and sometimes radiation therapy to kill the lymphoma cells in the body. This also kills normal stem cells in the marrow.
    • The donor stem cells are given to the patient through an intravenous (IV) line or central line.
    • The donor stem cells go from the patient’s blood to the marrow and help start a new supply of red blood cells, white blood cells and platelets.

This type of transplantation has been successful in some patients with HL after several relapses of the disease, but it is not commonly used as a treatment for HL. It is generally only done if a patient relapses after an autologous transplant.

Other patients may benefit from a reduced-intensity allogeneic stem cell transplantation, a treatment that uses lower doses of chemotherapy than a standard allogeneic transplant. Research is being done to compare this treatment to other treatments.

 

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