Stem cell transplant for childhood Hodgkin lymphoma

A stem cell transplant is sometimes used to treat childhood Hodgkin lymphoma (HL). It is used to replace stem cells when stem cells or bone marrow are damaged. A stem cell transplant is very risky and complex, and the procedure must be done in a specialized transplant centre or hospital.

Stem cells are found in the bone marrow, the bloodstream and umbilical cords. They are basic cells that develop into different types of cells that have different jobs. For example, all our blood cells develop from blood stem cells.

A stem cell transplant uses high-dose chemotherapy to kill all of the cells in the bone marrow. This includes both healthy cells and the lymphoma cells. After high-dose chemotherapy, healthy stem cells are given to replace the ones in the bone marrow that were destroyed.

Your child may be offered a stem cell transplant to treat HL if:

  • the cancer does not respond to other treatments or is resistant to treatment
  • the cancer comes back (recurs, or relapses) after treatment

Types of transplants used for childhood HL

The following types of stem cell transplant may be used with childhood HL.

Autologous

Autologous transplants are the most common type used to treat resistant or recurrent childhood HL. In this type of transplant, the stem cells are taken from the child’s own blood or bone marrow.

Allogeneic

Allogeneic transplants may be used in a clinical trial to treat resistant or recurrent childhood HL.

In this type of transplant, the stem cells are taken from one person (the donor) and are given to the child receiving the transplant (the recipient). The donor may be a relative or may not be related to the child. The donor and recipient are matched through a process called human leukocyte antigen (HLA) typing.

Side effects

Side effects can happen with any type of treatment for HL, but every child’s experience is different. Some children have many side effects. Other children have only a few side effects.

Side effects can develop any time during, immediately after or a few days or weeks after a stem cell transplant. Sometimes late side effects develop months or years after a stem cell transplant. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of a stem cell transplant will depend mainly on the type of chemotherapy drug or drug combination given, if radiation therapy was given, the type of transplant and the child’s overall health. Find out more about side effects of a stem cell transplant.

Side effects can develop months or years after treatment for childhood HL. Find out more about late effects for childhood HL.

Tell the healthcare team if your child has side effects you think might be from a stem cell transplant. The sooner you tell them of any problems, the sooner they can suggest ways to help your child deal with them.

Questions to ask about stem cell transplant

Find out more about stem cell transplant. To make the decisions that are right for your child, ask your healthcare team questions about stem cell transplant.

Expert review and references

  • Lymphoma-Hodgkin-Childhood. American Society of Clinical Oncology (ASCO). Cancer.Net. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 07.
  • Androkites, A.L . Hodgkin's disease. Kline, N. E. (Ed.). Essentials of Pediatric Oncology Nursing: A Core Curriculum. 2nd ed. Association of Pediatric Oncology Nurses; 2004: 2.4:pp. 27-30.
  • Hudson, M. M., Mihaela, O. and Donaldson S. S . Hodgkin lymphoma. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006: 23:695-719.
  • Leukemia & Lymphoma Society. Cord Blood Stem Cell Transplantation. New York: The Leukemia & Lymphoma Society; 2007.
  • Liebhauser, P . Hodgkin's Disease. Baggott, C. R., Kelly, K. P., Fochtman, D. et al. Nursing Care of Children and Adolescents with Cancer. 3rd ed. Philadelphia, PA: W. B. Saunders Company; 2002: 22: pp. 524-535.
  • Metzger ML, Krasin MJ, Choi JK, Hudson MM . Hodgkin lymphoma. Pizzo PA & Poplack DG (eds.). Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia: Wolters Kluwer; 2016: 22:568-586.
  • National Cancer Institute. Childhood Hodgkin Cancer Treatment (PDQ®) Patient Version. 2018.
  • National Cancer Institute. Childhood Hodgkin Lymphoma Treatment (PDQ®) Health Professional Version. 2018: http://www.cancer.gov/.

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