NCCN Guidelines for Patients® | Follicular Lymphoma Grade 1-2

32 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 3 Overview of cancer treatments Blood stem cell transplant Acute effects Acute effects are those that happen during treatment or shortly after the last session. Many people feel fatigue. Changes in skin are also common right after treatment. Your treated skin may look and feel as if it has a mild sunburn. It may also become dry, sore, and feel painful when touched. You may also have short-term hair loss, but only where treated. Treatment to the head and neck can cause mouth sores, dry mouth, changes in taste, and a sore throat. Chest radiation can cause a dry cough or a sensation of a lump when you swallow. Radiation near your belly can cause nausea and maybe vomiting, and when given between your hip bones, diarrhea and cramps. Late effects Late effects are those that happen after treatment. Some do not go away. The effects depend on the treatment site. Examples include dry mouth, dental cavities, hypothyroidism, lung scarring, heart disease, infertility, and second cancers. Not all side effects of radiation are listed here. Please ask your treatment team for a complete list of common and rare side effects. If a side effect bothers you, tell your treatment team. There may be ways to help you feel better. There are also ways to prevent some side effects. Blood stem cell transplant Blood (hematopoietic) stem cells are cells from which all blood cells are formed. They mainly exist in bone marrow. Cancer or its treatment can damage or destroy blood stem cells. A blood stem cell transplant replaces damaged or destroyed stem cells with healthy stem cells. The healthy stem cells form new marrow and blood cells. A transplant is sometimes an option for advanced follicular lymphoma. There are two types of blood stem cell transplant. Autologous blood stem cell transplant Autologous blood stem cell transplant uses your healthy stem cells to repair bone marrow. This treatment is also called HDT/ASCR ( h igh- d ose t herapy with a utologous s tem c ell r escue). Your healthy stem cells will be collected when imaging tests show that cancer treatment is working. You will then receive intense chemotherapy and maybe radiation to destroy any remaining cancer cells. This intense treatment will also destroy bone marrow. Your healthy stem cells will be put back into your body to “rescue” your marrow. Allogeneic blood stem cell transplant Allogeneic blood stem cell transplant uses healthy stem cells from a donor. HLA ( h uman l eukocyte a ntigen) typing is the test used to check if the donor and your tissue type are a good fit. Chemotherapy will be given to destroy cancer cells and suppress your immune system from attacking the donor cells. The transplanted stem cells will form new marrow and attack remaining cancer cells. This attack is known as the GVT ( g raft- v ersus- t umor) effect. On the other hand, there is a serious risk of GVHD ( g raft- v ersus- h ost d isease). GVHD is when the donated cells see the cells in your body as foreign and attack them.