Bone marrow/stem cell transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) are considered in individual cases for CTCL. Very high doses of chemotherapy or radiation may be needed to destroy cancer cells, and in some cases, another individual’s immune system to control remaining cancer cells. During transplantation, normal bone marrow is destroyed and is restored with a transplant of bone marrow or stem cells. Bone marrow and blood contain stem cells which are the “mother” of all blood cells formed in the bone marrow.
As transplants place a great strain on a body, there are not options for every patient. Age, medical history, cancer stage, response to previous treatment, and chances for a successful transplant are among the things that are considered when a transplant is proposed.
Allogeneic transplants are the most common type of transplant performed for CTCL, that is a transplant where the stem cells are donated by a different person than the patient. In an allogeneic transplant, finding a suitable donor, one that has a tissue or HLA type (different from blood type) close to the patient is important. If the donor’s cells are very unlike the patients’, they may react against the patient’s cells in the body and cause a condition called graft vs. host disease (GVHD).
The transplant is administered through the blood, and the stem cells travel to the patient’s bone marrow and slowly begin to make a new healthy bone marrow. In the time when the new bone marrow is being created, the patient is more susceptible to infection and bleeding.
“Mini” transplants are those where the stems cells are allogeneic, and the patient receives less chemotherapy before the transplant. GVHD is still a frequent and sometimes serious side effect.