在过去的10年里，癌症治疗的进步和支持治疗的改善改善了血液和骨髓移植(BMT)的结果和耐受性。. However, BMT remains a major procedure. For allogeneic transplantation, 患者接受来自组织匹配(hla匹配)供者的骨髓或血液干细胞，供者可能是也可能不是其亲属. Identical twin allogeneic transplants are called syngeneic transplants.
Allogeneic Transplant
Preparation
你会在开始高剂量预备治疗的那天入院. Your admission date may be changed based on your health status or bed availability. The length of your admission will be about four to six weeks.
Procedure
High Dose Chemotherapy
Chemotherapy begins soon after you are admitted to the hospital. Your doctor will discuss all the drugs you will receive and their side effects. 你的执业护士、住院护士和药剂师也会回答你的问题. In addition, you may receive written information on these drugs in a consent form.
Precautions are taken to minimize side effects from these drugs. For example, when receiving some types of chemotherapy, 患者必须每天彻底淋浴两次，以清除通过皮肤排出的药物，这样做有助于防止或减少化疗烧伤. 住院护士会详细说明你可能需要采取的其他特别预防措施.
Total Body Irradiation
Some patients receive total body irradiation (TBI) in addition to chemotherapy. 这种放射疗法旨在摧毁残留的癌细胞，进一步抑制免疫系统.
创伤性脑损伤的治疗在放射治疗部门进行，通常持续三到四天. The treatment itself is painless, but there may be uncomfortable side effects after treatment, such as mouth and throat sores, nausea, stomach and intestinal irritations, and skin redness. Antinausea medication is usually given before each treatment to reduce nausea.
The Transplant Procedure
移植的造血干细胞或骨髓将在最后一次化疗或放射治疗后1 ~ 3天内注入. The day of transplantation is referred to as Day 0. 移植前的天数为负天数，移植后的天数为正天数.
移植手术类似于简单的输血，将在你的病房里进行. You may have a family member in the room with you if you wish. 实际的过程大约需要一个小时，取决于干细胞的体积. 血液干细胞将通过你的中心静脉导管输入就像常规输血一样. Your nurse will check your blood pressure, temperature, breathing and pulse, and will watch for any side effects.
Usually there are no side effects, but occasionally patients may experience chills, flushing of the face, nausea and vomiting, headache, and changes in blood pressure and breathing. Your urine also may be tinged red for the first 24 hours after transplantation. If your urine remains red after this time or becomes red later, tell your nurse.
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Waiting for Engraftment
The new bone marrow does not recover immediately after it has been transplanted. The stem cells of the transplanted marrow will travel to the bones, reseed the marrow space, 在成熟细胞从骨髓释放到血液之前，要经历一个生长过程. 大约需要两到三周的时间，你的骨髓才会开始产生白细胞, red blood cells and platelets.
移植是一个术语，用来描述你的新骨髓何时开始发挥功能并产生血细胞. 在等待移植的过程中，没有成熟细胞离开骨髓进入血液. 你的血球计数将显示非常低的数值，你将需要由健康护理小组仔细监测. 我们的目标是为你提供红细胞和血小板，直到你再次产生细胞. 你还需要抗生素来防止细菌、真菌和病毒的感染.
Recovery
Delayed Side Effects
BMT后大约一周，身体会感受到化疗或放疗的影响. 当血液计数低时，你会觉得自己得了流感，可能不想做太多事情. This will last for about two weeks and will decrease as your blood counts improve. You may notice a number of other symptoms as well, including:
- Loss of appetite
- Nausea and vomiting
- Changes in vision
- Mouth and throat soreness
- Diarrhea
- Difficulty sleeping and fatigue
- Infection
- Hair loss
- Skin reactions
- Graft-versus-host disease
Preparing to Leave the Hospital
当你的中性粒细胞计数上升时，你的团队会开始和你谈论出院. 你需要确保在你出院后有人陪着你, 协助您的日常需求，并为您的诊所访问提供交通服务. 你和一个家庭成员将学习如何照顾你的导管和所有关于你的药物.
To be discharged, you will need to be:
- Walking
- Eating at least 1,000 calories daily
- Drinking at least one quart of fluid daily
- Free of active medical problems
- Without a fever
- Off most intravenous medications and taking your pills without problems
- Show that you can care for your intravenous catheter
A case manager will assist with arrangements for home care. 执业护士会检查你的出院和门诊指示，药剂师会和你一起检查你的药物.
Routine Outpatient Visits
移植后，您的BMT十大赌博平台排行榜和执业护士将密切关注您. 你会做血液检查，如果有必要，还会给你静脉注射药物或液体. 预计在血液学/BMT诊所每周两次，至少两到三个月.
Keeping Healthy
在同种异体骨髓移植后的至少6到12个月内，即使你的身体再次产生白细胞，你的感染风险仍将高于正常水平. You will be instructed on how to help prevent infection, including washing your hands, avoiding large crowds and refraining from smoking cigarettes or marijuana.
The Caregiver's Role
所有接受同种异体骨髓或干细胞移植的患者都必须有一名身份明确的人员在他们出院后给予协助. We call this person the "caregiver.“为了获得同种异体BMT的批准，每个患者必须确定一个或几个能够履行照顾者职责的人, which include:
- Providing emotional support
- Providing physical support
- Gathering and reporting information
- Caring for a central venous catheter
- Managing and understanding medications
UCSF Health medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
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