If your cancer is not responding to chemotherapy or radiation, you may receive bone marrow transplantation or peripheral stem cell transplantation. For each of these therapies, chemotherapy drugs are given first to rid the body of the cancer cells. The chemotherapy kills healthy cells as well. The transplanted stem cells replace the missing disease-free cells.
These methods are still investigational, but they are thought to be effective because Hodgkin’s disease usually responds to chemotherapy. In addition, most patients are young and better able to withstand these intense therapies.
This page discusses the use of bone marrow and peripheral stem cell transplantation for Hodgkin disease, for a more general discussion of these therapies for cancer treatment, please see the bone marrow transplant treatment monograph.
Bone marrow is a soft, sponge-like materiel found inside certain bones, such as the heads of the femur and humerus, the sternum, and the hip bones. Bone marrow contains immature cells called stem cells. Stem cells can mature into blood cells (white blood cells, red blood cells, and platelets), which are often damaged by cancer. Stem cells are predominately found in the bone marrow, but some occupy the bloodstream. Those in the blood stream are called peripheral blood stem cells (PBSCs). If PBSCs are used in the transplant, it is referred to as peripheral blood stem cell transplantation (PBSCT).
For a stem cell transplant, stem cells from the peripheral blood or bone marrow are collected (harvested) and placed in frozen storage prior to treatment of the cancer with high-dose chemotherapy. Once chemotherapy treatment is complete, the stem cells are put back into your body; they enter your blood stream and travel to your bone marrow where they replace damaged stem cells and begin to make healthy blood cells. If your own stem cells are used the transplant is called autologous. If a donor's cells are used, it is called and allogeneic transplant.
Stem cell transplantation for Hodgkin’s disease usually involves harvesting the patient’s stem cells, from the bone marrow or blood, rather than from a donor. Hodgkin’s disease rarely affects the bone marrow, so cells from the patient are usually cancer-free.
Effectiveness varies from 10% disease-free survival to 40% to 70% disease-free survival, depending on how much disease is present at the time of treatment. Bone marrow transplantation is most effective when started soon after relapse.
Stem cell transplantation is usually only done if Hodgkin’s disease recurs. Infertility may occur due to treatment with some of the drugs ordered. If fertility is a concern of yours, talk with your doctor about the possibility of storing sperm or eggs before starting treatment.
Call your doctor if you develop any of the following:
For a thorough description of bone marrow and peripheral stem cell transplantation, see the bone marrow transplant treatment monograph.
National Cancer Institute, National Institutes of Health
The Leukemia & Lymphoma Society
American Cancer Society
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Last reviewed September 2009 by Mohei Abouzied, MD Last Updated: 9/30/9