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.
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
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.