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What to Know About Stem Cell Transplant for Hodgkin Disease

A stem cell transplant may be used if other treatments such as standard chemotherapy don't completely get rid of the lymphoma. This treatment uses high doses of chemotherapy (and sometimes radiation to the whole body). Your body would normally not be able to handle such high doses because all the bone marrow stem cells and many other cells would be destroyed. However, after the high-dose treatments, you are rescued by having healthy new stem cells transplanted. Stem cells are immature cells that are the starter cells for all types of tissue. Stem cells in the bone marrow and blood form new blood cells.

There are two kinds of stem cell transplants, depending on the source of the transplant cells:

  • An allogeneic transplant means the stem cells come from another person whose cell type is almost exactly like yours.

  • An autologous transplant means the stem cells are collected from your own body and preserved before you get chemotherapy.

In most cases, the process for collecting stem cells is a lot like giving blood, but it takes longer. A small tube, called a catheter, is used to obtain blood from your vein or that of the donor. The blood goes to a cell separation device to remove the stem cells needed. Then the extra blood is returned to you or the donor. This process may need to be repeated more than once to collect the right amount of cells for you. Occasionally, stem cells must be collected from the bone marrow rather than the blood.

Autologous transplants are usually preferred over allogeneic transplants for Hodgkin disease because of the lower risk of serious side effects, but they can have their own issues. For example, they may be slightly less likely to completely destroy the lymphoma. Allogeneic transplants are usually reserved for people in whom an autologous transplant did not work. 

After the transplant, you may stay in the hospital for at least several weeks. The new bone marrow has to produce enough white and red blood cells, as well as platelets. Until it does, you must be protected from infections, which can result from having reduced white blood cell counts. You’ll get transfusions if your levels of red cells or platelets are low. You are at greatest risk for infection right after the transplant. You must work closely with your doctors and nurses to prevent or treat infections or bleeding.

Potential side effects from stem cell transplant for Hodgkin disease

Most of the short-term side effects of stem cell transplantation are from the high doses of chemotherapy. These should go away as you recover from the transplant. You may also experience a strange taste in your mouth from the preservative used to freeze the stem cells. These are some common side effects:

  • Low blood cell counts

  • Infection

  • Feeling tired

  • Bleeding

  • Nausea

  • Vomiting

  • Loss of appetite

  • Mouth sores

  • Diarrhea

  • Hair loss

  • Fever or chills

  • Shortness of breath

  • Tightness or pain in the chest

  • Low blood pressure

  • Coughing

  • Weakness

Some side effects may be long-lasting or appear years later. These are possible long-term side effects:

  • Shortness of breath, often caused by radiation damage to the lungs

  • Skin rashes with itching, nausea, mouth sores, severe diarrhea, fatigue, jaundice (yellowing of the skin), and muscle aches. These symptoms may indicate graft-versus-host disease, a condition that occurs if the immune system cells in the donor's stem cells attack your skin, liver, gastrointestinal tract, mouth, or other organs. This is a possible side effect of allogeneic transplants, but not autologous transplants

  • Lack of menstrual periods, which may indicate ovary damage and cause infertility

  • Infertility in men

  • Weight changes

  • Vision problems, such as blurriness or cloudiness, caused by damage to the lens of the eye

  • Bone pain caused from damage due to lack of blood supply called aseptic necrosis

  • Problems with metabolism caused by damage to the thyroid gland

  • Development of another cancer, such as a leukemia, years later