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Autologous stem cell transplant

Silver02
Posts: 14
Joined: Apr 2021

Hello, I hope all is doing well

I was looking for posts regarding stem cell transplant but didn't find any so thought of making one. if you have had a stem cell transplant please do share your experience especially how you coped with the side effects post discharge, its concerning me the most.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3663
Joined: May 2012

Silver02,

Many of the folks here have had SCTs (I have not).   PoGuy, a regular, has relapsed 3 or 4 times, and has had I think two, but possibly 3, SCTs.  In total, he has received about 20 or 21 different chemo drugs.  Private Message him, or I'm sure he will check in soon.   Follicular NHL is notorious for relapse; a very commonn thing with that strain.

Silver02
Posts: 14
Joined: Apr 2021

Thank you so much for the input! Appreciate it

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3663
Joined: May 2012

In a more optimistic tone, I might add that follicular is usually well-maintained after relapse, or multiple relapses.  And for clarification, Po's lymphomas have been extremely rare T-cell varieties (and not any form of follicular).   Follicular is a very common strain, the most common indolent form of NHL.  Therefore, it receives a huge amount of research. 

My disease, NLPHL, is 'sort of' the Hodgkin's equivalent to NHL follicular, in that it is very indolent also, and also subject to relapse.   But it is very rare, constituting only about 1 in every 200 lymphoma cases in the US or world.  I was reading a British journal several years ago, published by their institute of health.   It had an article about NLPHL, and saiid that England had had eight (8) known cases of NLPHL the previous year.  That gives you an idea.   Therefore, it receives virtually no research at all, and almost never any clinical studies.   A SCT for you should (statistically) yield very long term, if not permanent, remission.

Silver02
Posts: 14
Joined: Apr 2021

Thank you for taking the time to explain about follicular lymphoma.

I'm so sorry for not being clear at the beginning, I was diagnosed with mixed cellularity hodgkins lymphoma which then was categorized as recurrent refractory. The doctors said my best option was to get an autologous transplant which I did. I am currently 45 days post transplant. however, I'm still skeptical. the doctors say that my NED chances are very high but I heard that before and it wasn't. I don't know what to put my faith in. I'm just crossing my fingers for my 100 day pet scan.

po18guy's picture
po18guy
Posts: 1192
Joined: Nov 2011

Where to begin? Are you cponsidering a transplant? Scheduled for one? Recently underswent a transplant? All have answers with different needs, so to speak. As to autologous transplants, as a general rule they are difficult going into, but easier coming out of. Also generally, the intention is to completely ablate your marrow - destroy it in medical terms. To do this, there is an intense chemotherapy conditioning regimen, as well as the possibility of localized or even total body irradaition. Chemotherapy is administered on the order of 5-10 times normal strength. The thinking is that in such a chemo-saturated environment, no cancer cell could survive. Being in full response - complete remission - is the ideal condition for transplant.

Since it is so intense, how does the patient survive? Well, it is done very short term, so that the typical cumulative effects of chemotherapy do not occur. Think of holding your hand over a burning candle. You would be severely burned. However, if you wave your hand over the candle, the same heat is applied, but for a much shorter time. Thus, damage is limited. If radiation is used, the dosage may be less than usual, as it is used in conjunction with the intense chemotherapy. 

Autologous transplants, in which you receive your own blood stem cells, have virtually zero potential for graft-versus-host-disease, a condition similar to transplant rejection issues in organ transplants. There is a ton more, but this touches on the basics.  

janekren
Posts: 6
Joined: Apr 2021

Hi po18guy!

I am trying to decide between an auto vs reduced intensity allo.  My understanding is that with auto, the high toxicity of the chemo is the treatment and with allo, the new marrow is the treatment and the chemo is only enough to weaken your immune system to accept the graft.  My concern is another relapse after the auto and having to undergo another BMT (allo).  I have already relapsed 3 times (twice after rituximab alone, once after obinituzimab + Bendamustine while in maintenance).  I just finished Rituximab + lenalidomide in Feb, but they expect that to only give me about a 12 month remission, so they want me to do a BMT now.  My MD is saying auto, but the MD I got a second opinion from is saying the reduced intensity allo is the way to go.  I don't know how to decide!  I really don't want to have a second BMT and from what the second MD said, the allo gives me a 70% chance of a cure!  Do you have any experience with allogenic transplants and the risks/complications with GVHD? 

Jane

po18guy's picture
po18guy
Posts: 1192
Joined: Nov 2011

....are T-Cell Lymphomas from the much more common B-Cell Lymphomas. It seems that B-Cells respond to autologous transplants even after relapse, whereas autologous transplants after relapse with T-Cell Lymphomas are far more likely to fail. Even if you undergo an autologous transplant and it eventually fails ("IF!"), you still have the option of an allogeneic transplant. As well, you have the meantime to seek a donor, just in case. GvHD, while much better controlled than in past yearsm can still be fatal - something to ponder seriously. I would carefully consider the advice of your hematologist. If you do not have a hematologist, but rather an oncologist, it is good to seek a second opinion on transplant from a transplant hematologist. 

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