High-dose Chemotherapy and Stem Cell Transplant for Hodgkin Lymphoma
Stem cell transplants (SCTs) are sometimes used for hard-to-treat Hodgkin lymphoma, such as disease that doesn’t go away completely after chemotherapy (chemo) and/or radiation or if it comes back after treatment.
The doses of chemo drugs given to patients normally are limited by the side effects these drugs cause. Higher doses can’t be used, even if they might kill more cancer cells, because they would severely damage the bone marrow, where new blood cells are made.
A stem cell transplant lets doctors give higher doses of chemo (sometimes along with radiation therapy). This is because after getting high-dose chemo treatment, the patient receives a transplant of blood-forming stem cells to restore the bone marrow.
The blood-forming stem cells used for a transplant can come either from the blood or from the bone marrow.
Types of transplants
There are 2 main types of stem cell transplants. They use different sources of blood-forming stem cells.
- In an autologous stem cell transplant, a patient’s own blood stem cells are collected from bone marrow or blood several times in the weeks before treatment. The cells are frozen and stored while the person gets treatment (high-dose chemo and/or radiation) and then are given back into the patient’s blood by an IV. This is the more common type of transplant for Hodgkin lymphoma.
- In an allogeneic stem cell transplant, the blood stem cells come from someone else. Usually this is a brother or sister, although the source may be an unrelated donor or umbilical cord blood. The donor’s tissue type (also known as the HLA type) needs to match the patient’s tissue type as closely as possible to help prevent major problems with the transplant. In treating Hodgkin lymphoma, an allogeneic transplant is generally used only if an autologous transplant has already been tried without success.
A stem cell transplant is a complex treatment that can cause life-threatening side effects. If the doctors think a person might benefit from a transplant, it should be done at a cancer center where the staff has experience with the procedure and with managing the recovery phase.
For more on stem cell transplants, see Stem Cell Transplant for Cancer.
Bartlett NL, Foyil KV. Chapter 105: Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.
National Cancer Institute. Physician Data Query (PDQ). Adult Hodgkin Lymphoma Treatment. 2016. Accessed at www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq on April 20, 2016.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Hodgkin Lymphoma. Version 2.2016. Accessed at www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf on April 20, 2016.
Younes A, Carbone A, Johnson P, Dabaja B, Ansell S, Kuruvilla J. Chapter 102: Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Last Medical Review: February 10, 2017 Last Revised: March 29, 2017
- Chemotherapy for Hodgkin Lymphoma
- Radiation Therapy for Hodgkin Lymphoma
- Immunotherapy for Hodgkin Lymphoma
- High-dose Chemotherapy and Stem Cell Transplant for Hodgkin Lymphoma
- Treating Classic Hodgkin Lymphoma, by Stage
- Treating Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
- Treating Hodgkin Lymphoma in Children
- Treating Hodgkin Lymphoma in Pregnancy