Stem Cell Transplant for Lymphoma in Children

A stem cell transplant (SCT) can sometimes be used to help improve the chances of curing lymphoma. You might also hear this called a bone marrow transplant or a hematopoietic stem cell transplant.

SCT is not used as the first treatment for lymphoma in children, but it might be an option if the first treatment doesn’t work or if the lymphoma comes back after treatment.

Why are stem cell transplants used for lymphoma in children?

High doses of chemo can be more effective at killing cancer cells. But this amount of chemo can also cause serious or even life-threatening side effects, such as damage to the bone marrow.

Stem cell transplant allows some children with lymphoma to get the high doses of chemo they need, because the transplant replaces their blood-forming stem cells and immune system after these are destroyed by the chemo.

How is SCT different from solid organ transplants?

Compared to solid organ transplants that work immediately, SCT instead “plants the seeds” that allow new bone marrow to grow and make blood cells.

First, high-dose chemotherapy destroys the lymphoma, along with the bone marrow where new blood cells are formed. Next, a stem cell transplant replaces the blood-forming stem cells and immune system in the bone marrow that were killed by the chemo. It can take weeks or months after the transplant before a child’s bone marrow is able to make all the blood cells on its own.

To learn more about this process, see Stem Cell Transplant for Cancer.

Types of SCT used for lymphoma in children

There are two main types of stem cell transplant (SCT) that might be considered when treating lymphoma in a child or teen.  

• Autologous SCT uses a child’s own blood-forming stem cells. This is the most common type of transplant used for lymphoma in children.
• Allogeneic SCT uses blood-forming stem cells from a donor. This type of SCT is used less often for lymphoma in children, but it might be another option.

Autologous (auto) stem cell transplant

For this transplant, a child’s own stem cells are collected (harvested) several times in the weeks before treatment. The cells are frozen and stored while the child gets treatment with high-dose chemo and/or radiation.

The high doses of chemo destroy the normal bone marrow cells along with the cancer cells. After treatment, the child’s frozen stem cells are thawed and returned to their body through an IV, similar to a blood transfusion.

Auto SCT is the most common type of transplant used to treat lymphoma in children. However, using a child’s own stem cells might not be an option if the lymphoma has spread to their bone marrow or if they have a lymphoblastic lymphoma.

Allogeneic (allo) stem cell transplant

The stem cells used in an allogeneic SCT come from someone else (a donor). The donor’s tissue type, also known as the HLA type, needs to match the child’s tissue type as closely as possible to limit the risk of major problems. 

This donor may be a sibling with the same tissue type. Or it may be an HLA-matched, unrelated donor. This is a stranger who has volunteered to donate cells. You can learn more about this in Finding a Stem Cell Donor.

Sometimes umbilical cord blood stem cells are used. These come from blood drained from the umbilical cord and placenta after a baby is born and the umbilical cord is cut. This blood is rich in stem cells. Whatever the source, the stem cells are then frozen and stored until they are needed for the transplant.

Deciding on a stem cell transplant for your child

SCT isn't used as much to treat lymphoma because other treatments generally work well and a transplant can have severe side effects that make it hard to tolerate.

A stem cell transplant is a complex treatment that can cause serious, possibly even life-threatening side effects. If your child’s cancer care team thinks they might benefit from a transplant, it should be done at a center where the staff has experience with the procedure and managing the recovery phase.

Talk with the cancer care team beforehand to learn about possible long-term effects your child may have. You can find more information about this in Late and Long-term Effects of Treatment for Lymphoma in Children.