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NCCN Guidelines for Patients


Hodgkin Lymphoma, Version 1.2015


Overview of cancer treatments Stem cell transplant

Apheresis typically takes 4 to 6 hours and does not

require anesthesia. It may take two or more sessions

to obtain enough stem cells. During the procedure,

you may have lightheadedness, chills, numbness

around the lips, and cramping in the hands.

Bone marrow aspiration is used to remove bone

marrow. For this procedure, you will be given either

regional anesthesia or general anesthesia. Next, a

needle will be inserted through your skin into your hip

bone to draw out the bone marrow. Rarely, marrow is

removed from the breastbone. The needle must be

inserted many times into one or more spots to collect

enough marrow. The marrow will then be processed to

collect the stem cells.

Collection of the bone marrow takes about 1 hour.

Your entire hospital stay will likely be 6 to 8 hours

which, includes recovery time. The aspiration will

likely cause some pain and soreness for a few days.

Anesthesia may cause nausea, headache, and


After apheresis or aspiration, your harvested cells

will be combined with a preservative. Then, they will

be frozen and stored to keep them alive until the

transplant. This process is called cryopreservation.

High-dose chemotherapy

After your stem cells have been harvested, you will

receive high doses of chemotherapy. High doses are

given so that your body can’t make stem cells. High-

dose chemotherapy also destroys normal cells in the

bone marrow. This greatly weakens your immune

system so that your body doesn’t kill the transplanted

stem cells. Not every person can tolerate high-dose

chemotherapy before the transplant. Side effects of

chemotherapy are described in the prior section.

Transplanting stem cells

When chemotherapy is completed, your harvested

stem cells will be put back into your body. A

transfusion will be used. A transfusion is a slow

injection of blood products through a central line into

a large vein. A central line (or central venous catheter)

is a thin tube. The tube will be inserted into your skin

through one cut then into your vein through a second

cut. Local anesthesia will be used. This process can

take several hours to complete.

The transplanted stem cells will travel to your bone

marrow and grow. New, healthy blood cells will form.

This is called engraftment. It usually takes about 2 to

4 weeks.

Until then, you will have little or no immune defense.

You will need to stay in a very clean room at the

hospital. You may be given an antibiotic to prevent

or treat infection. You may also be given a blood

transfusion to prevent bleeding and to treat low red

blood counts (anemia). While waiting for the cells to

engraft, you will likely feel tired and weak.