骨髓移植 可以用自己的骨髓来进行，叫做an 自体骨髓移植或者使用另一个人的骨髓，称为an 异基因骨髓移植. The type of bone 骨髓 transplant used in any individual situation is determined through an in-depth evaluation and is beyond the scope of this text. If you have questions concerning the type of transplant recommended in your particular case, 你可以咨询加州大学旧金山分校的BMT利来登录进行全面评估.
An 异基因骨髓移植 offers potentially curative therapy to patients with a variety of cancers including:
An essential component of allogeneic transplantation is to identify a human leukocyte antigens (HLA)-matched bone 骨髓 donor. Ideally, a brother, sister or possibly another family member can serve as the bone 骨髓 donor. 然而，许多患者没有合适的家庭成员作为捐赠.
对那些没有家庭捐赠者的病人, the National Marrow Donor Program (NMPD) provides a service to locate HLA-matched unrelated donors (MUD transplantation). 目前, there are approximately five million volunteer bone 骨髓 donors registered with the NMDP. 一个额外的40,000 new donors are added to the registry each month and the NMDP facilitates over 1,每年有000例泥浆移植.
If you or a family member has questions regarding matched unrelated donor transplantation you may contact the UCSF血液和骨髓项目，你当地的nmdp批准的移植中心或国家骨髓捐赠计划. 如果你或你的家人想成为骨髓捐赠者，那就去吧 www.骨髓.org 或致电1-800-MARROW-2获取更多信息.
The Bone Marrow Transplantation Program at UCSF is certified by the NMDP to facilitate unrelated donor searches and transplants. The process begins with a simple blood test designed to evaluate the recipient's HLA genes. 这血液试验, 叫做HLA打字, identifies antigens or proteins located on the surface of their cells that are important for immune function.
一旦知道病人的hla类型，就可以进行初步检查. The preliminary search is a computerized search designed to identify potential bone 骨髓 donors that have similar HLA antigens. 初步调查的详细报告通常在24小时内提供. The preliminary search is free of charge and no donors are contacted during this phase of donor searching.
If the preliminary search is successful in identifying potential donors and the recipient and doctor decide an unrelated transplant is necessary, 可以开始正式的搜索. 只有nmdp批准的癌症中心，比如加州大学旧金山分校，才能发起正式的搜索. 在这个过程中, potential donors are contacted and blood samples are obtained to confirm HLA-typing and perform other screening tests. These additional blood tests are more specialized and are designed to determine which donor is the best possible match.
一旦找到并选择了最好的捐献者, the donor visits an NMDP-approved collection center to learn more about the collection process. The donor will attend an information session and will have a complete physical examination with more blood tests. As long as the donor passes all the examinations, a date for transplantation can be determined.
寻找不相关的捐赠者是一个复杂而耗时的过程. 平均来说，完成搜索过程需要三到六个月的时间. 因此, it is imperative to begin the unrelated search process as soon as possible. You can consult a BMT doctor at UCSF to determine if and when an unrelated search should be initiated.
The main goal of the immune system is to protect the body against abnormal or foreign substances like bacteria, 病毒，甚至癌细胞. The immune system must be able to distinguish between the body's own cells termed "self" and other substances termed "non-self.“这一点很重要，这样免疫系统就不会与自身的正常细胞作战, 而是专门针对异常细胞或物质.
HLA系统提供了正常免疫功能所必需的“自我”信号. HLA基因编码停留在人类细胞表面的抗原或蛋白质. These proteins act like flags and allow the body's immune system to recognize the substances as self. 外来物质, 没有这些标志, 被认为是非自我的并且受到免疫系统的攻击. There are many different HLA antigens and everybody has their own unique set of cell-surface proteins (or flags).
寻找骨髓捐献者的时候, we attempt to match six specific HLA antigens between the donor and the patient — a six out of six match. The goal is to match the donor's and recipient's immune systems so that the flags on their cell surfaces appear similar. 因此, 当新的供体免疫系统在受体体内形成时, 新的免疫系统会将接受者的细胞识别为自身. If the new immune system identifies the recipient's body or cells as abnormal (in other words, 它), 新的免疫系统会攻击接受者的身体. 这被称为移植物抗宿主病, 供体的免疫系统对抗受体的身体.
配型越好，移植物抗宿主病的几率越低. 然而, 即使供体和受体的六种hla抗原都匹配, 移植物抗宿主病仍然可能发生. Other genes are likely important for graft-versus-host disease and more research is needed to enhance our understanding.
HLA typing requires a specialized laboratory equipped with experts in transplant biology and HLA gene analysis. The process identifies the HLA A, B, C和DR抗原 present on the donor's and recipient's cells. 每个人有两种A, B, C和DR抗原, 一个遗传自母亲，另一个遗传自父亲.
Specialized high-resolution molecular typing is now performed on all genes A, B, C and DR. 这种特定的输入有时需要两到三个星期才能完成. 一旦我们收到加州大学旧金山分校的捐赠样本，我们就可以进行这种专门的分类. 目标是找到可能的最佳匹配.
骨髓移植协调员将监督HLA分型, the search process and the pre-transplant evaluation and testing of the donor and recipient. The bone 骨髓 transplant coordinator will have the most up-to-date information regarding the HLA searching process. If there are any questions regarding unrelated transplantation or the 骨髓 donation process you may contact your unrelated BMT coordinator at (415) 353-2220.
Dr. 托马斯•马丁 监督不相关的搜索过程. 联系电话:(415)353-2421.
加州大学旧金山分校的健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.