BMT- Lymphoma Autologous

Lymphoma is a type of cancer that attacks the immune system. There are two types of lymphomas, Hodgkin and non-Hodgkin lymphoma. The major symptom of lymphoma is the enlargement of lymph nodes that do not disappear as it is in the case of infections. Lymphoma treatment is possible with an autologous stem cell transplant.

An autologous stem cell transplant for lymphoma helps to restore the normal functioning of blood production by using the person’s own stem cells. A spongy type of substance in your bones, called bone marrow, helps making blood cells that include white blood cells, red blood cells and platelets.

Your blood cells die and are replaced by new blood cells throughout your life. When lymphoma (a type of cancer) attacks your bone marrow, it loses its ability to produce normal blood cells, thus affecting the immune system.  Lymphoma treatment procedures like chemotherapy or radiation, or a combination of both helps to destroy the cancerous cells, thus restoring the function of the stem cells. However, in the process, the stem cells (also called bone marrow) are completely damaged. Therefore, a bone marrow transplant is required to restore production of blood cells.

The term ‘’Autologous’’ means ‘’coming from you’’. Autologous stem cell transplant involves collecting your own stem cells and storing them separately. After the administration of high-dose of anti-cancer treatment, the stored stem cells are given back to you. This is more likely to treat lymphoma and make the remission last longer than any standard treatment of chemotherapy or radiation therapy.

Autologous stem cell transplant requires a lot of preparations that are discussed below:

A stem cell transplant is usually done for three reasons:

• If doctors feel that the lymphoma is likely to relapse
• If the lymphoma relapses after the previous cancer treatment
• If your lymphoma does not respond to the previous treatment

• Several weeks and months before the treatment of autologous lymphoma, you will have to go through rounds of discussions with your medical team.
• Several tests are done, such as, blood tests and other organ tests (including kidneys, heart, lung, etc) to assess your health condition and how well your organs are functioning.
• Some other scans and tests may be required to check the condition of your lymphoma.
• A central venous catheter is placed in the vein throughout the treatment to help your medical team administer drugs as required.
• The patient is prepared before stem cells are collected from the bloodstream. Daily injections are given to help move the stem cells from the bone marrow to your bloodstream. The number of injections given may vary from person to person, while the growth factor treatments are carried out for 7-10 days.       The injections can be given at home by self or by any of your family members, or a nurse arranged for you at home. It should, however, be known that these types of drugs are given after chemotherapy. High doses of chemotherapy help reduce lymphoma to a great extent and also help in enhancing your stem cells.
• There are certain side effects of the injections, noticeably bone and muscle pains and aches. Painkillers definitely help reduce the pain.
• When the doctor finds enough stem cells in your bloodstream through a blood test, he uses a ‘cell separator’ machine to collect the stem cells. A needle is injected through one arm and blood is drawn and passed into the machine. The machine separates stem cells from your blood and sends the rest of the blood through your other arm. It takes a few hours to complete the procedure.

This is how stem cell transplant is done:

• After stem cells are collected, they are stored and thawed. During this time, a high-dose of chemotherapy is given to ensure the treatment of lymphoma by reducing cancerous cells as much as possible. Sometimes, chemotherapy also helps in cell mobilisation (movement).
• It should, however, be kept in mind that a high dose of chemotherapy can affect fertility, so it’s likely you talk to your doctor regarding this if you want future pregnancy.
• On the day of the transfusion, the stem cells are given to you through a central nervous catheter inserted in your chest.
• If required, you are given bags of stem cells through the catheter. After transferring your own stem cells into your blood, new cells begin to produce in 1-3 weeks.

After stem cell transplant is over, you are kept under observation and given antibiotics to prevent infection. Doctors check your blood often to assess the levels of white blood cells, red blood cells and platelets in bloodstream. In most cases, you receive the treatment in an outpatient clinic, but you may have to stay in the hospital for almost 3 weeks, if your doctor feels it right.

The recovery time of autologous stem cell transplant takes over a year since your immune system returns to normal functioning only after a year or two. After the procedure of autologous bone marrow transplant, you will have to undergo biopsy tests for your bone marrows. Also, you will require several immunizations updates to assess how your body is functioning.