These treatments are used for children who relapse during or after treatment for non-Hodgkin lymphoma. They allow doctors to use higher doses of chemotherapy than would normally be tolerated. High-dose chemotherapy, sometimes along with radiation given to the entire body, destroys the bone marrow, which prevents new blood cells from being formed.

Doctors then repopulate the bone marrow by giving the child an infusion of blood-forming stem cells after treatment. These are able to create new bone marrow cells. These stem cells can either be taken from the child (autologous stem cell transplant) or donated from another person (allogeneic stem cell transplant).

Autologous stem cell transplant: In an autologous bone marrow transplant (BMT) or peripheral blood stem cell (PBSC) transplant, blood-forming stem cells are removed from your child's bone marrow or bloodstream before treatment. The bone marrow stem cells or PBSCs are carefully frozen and stored.

Your child then receives high doses of chemotherapy and sometimes radiation treatment. This destroys all cells in the bone marrow in addition to any remaining cancer cells. The frozen cells are thawed and returned to the child as a blood transfusion after the high-dose chemotherapy and possible radiation therapy.

This type of transplant is more common than an allogeneic transplant.

Allogeneic stem cell transplant: A transplant using cells from another person is called an allogeneic BMT or allogeneic PBSCT. Cells from another person may be used when lymphoma cells are found in a child's own bone marrow in order to avoid returning cancer cells to the child after treatment.

If the child has a brother or sister who has an identical tissue type, the sibling's bone marrow cells (or possibly PBSCs) can be used instead of the child’s own cells. If a parent is a close match to the child, the parent's cells can be used. Sometimes cells from a matched but unrelated donor may also be used.

Bone marrow or peripheral blood stem cell transplant is a complex treatment, requiring great skill. If the doctors think your child may benefit from transplantation, the best location for this procedure may be in a nationally recognized cancer center or a hospital associated with a university, where the staff has experience in performing the procedure and managing the side effects of the procedure during the recovery period.

To learn more about stem cell transplantation, see the American Cancer Society document Bone Marrow and Peripheral Blood Stem Cell Transplants.

Revised: 03/08/2007