自体移植

过程

高剂量化疗

Chemotherapy begins soon after you are admitted to the hospital, after stem cell collection. 你的利来登录会告诉你所有的药物和它们的副作用. Your nurse practitioner, inpatient nurse 和 pharmacist also will be available to answer questions. 此外，您可能会收到同意书中关于这些药物的书面信息.

采取了一些预防措施，尽量减少这些药物的副作用. 例如, 当接受某些类型的化疗时, patients must shower thoroughly twice a day to remove the drug that is excreted through the skin — this is done to help prevent or minimize chemotherapy burns. 住院护士会仔细检查你可能需要采取的任何特殊预防措施. Your doctor may also discuss medication (palifermin) to prevent some transplant-related complications prior to admission.

全身辐照

一些患者在化疗的同时接受全身照射(TBI). This radiation therapy is intended to destroy remaining cancer cells 和 further suppress the immune system.

TBI treatments are given in the radiotherapy department, usually over a period of three to four days. 治疗本身无痛, 但治疗后可能会有不舒服的副作用, 如口腔和喉咙痛, 恶心想吐, 胃和肠道刺激, 和皮肤发红. 通常在每次治疗前服用抗恶心药物以减少恶心. 您可能会接受额外的药物(帕利夫明)，以防止口腔溃疡.

移植过程

The transplant will occur one to three days after your last chemotherapy dose or anytime after your last radiation dose. 移植日被称为第0天. The days before the transplant are counted as minus days 和 the days after the transplant are plus days.

The procedure is similar to a simple blood transfusion 和 will be done in your hospital room. 如果你愿意，可以让你的家人和你一起在房间里. The actual procedure will take about 45 minutes, depending on the volume of stem cells. 如果你正在接受骨髓注射，可能需要几个小时. 血液干细胞将通过中心静脉导管注入.

你的护士会检查你的血压, 温度, 呼吸和脉搏, 并会注意任何副作用. 通常没有副作用, 但偶尔病人可能会在嘴里体验到一种奇怪的味道, 发冷, 洗脸, 恶心和呕吐, 头疼, 血压和呼吸的变化.

等待移植

新骨髓在移植后不会立即恢复. 移植的骨髓的干细胞会进入骨骼, reseed the marrow space 和 go through a growth process before the mature cells are released from the bone marrow into the blood stream. It will take eight to 14 days from the day of transplantation for your marrow to start producing white blood cells, 红细胞和血小板.

Engraftment is the term used to describe when your new marrow begins to function 和 produce cells. While awaiting engraftment, no mature cells leave the marrow 和 enter the blood stream. Your blood counts will show very low values 和 you will require careful monitoring by the health care team. The goal is to support you with red blood cell 和 platelet transfusion until you are producing cells again.

欲了解更多信息，请访问 血液计数和输血 部分的 自体移植指南.

复苏

延迟的副作用

The body feels the effects of the chemotherapy or radiation about a week after transplantation. When the blood counts are low, you feel like you have the flu 和 may not want to do much. 这将持续约两个星期，并将减少随着你的血细胞计数改善. 您可能还会注意到一些其他症状，包括:

• 食欲不振
• 恶心和呕吐
• 视觉的变化
• 口腔和喉咙疼痛
• 腹泻
• 睡眠困难和疲劳
• 感染
• 脱发
• 皮肤反应
• 移植物抗宿主病

有关这些副作用的详细信息，请参阅 治疗 部分的 自体移植指南.

准备出院

When your neutrophil count is over 1,000, your team will start talking to you about discharge. You will need to be sure that arrangements have been made for someone to stay with you after you are discharged, 协助您处理日常需要，并为您提供门诊接送服务. 你或你的家人将学习如何照顾你的导管.

要想出院，你需要做到:

• 走
• 每天至少摄入1000卡路里
• 每天至少喝一夸脱的液体
• 没有健康问题
• 没有发烧
• 停止静脉注射药物，按时服药
• 如果出院后需要的话，表明你可以照顾好静脉导管

个案经理将协助安排家庭护理. The nurse practitioner will go over your discharge 和 outpatient instructions 和 the pharmacist will review your medications with you.

常规门诊访问

Your BMT doctor 和 nurse practitioner will follow you closely after your transplantation. You will have blood work done 和, if necessary, will receive intravenous medications or fluids.

保持健康

Your risk of infection will remain higher than normal for at least three months after autologous BMT, 即使你的身体再次产生白细胞. The highest risk is within the first month of leaving the hospital; during this period you should spend most of your time at home 和 away from people, 这就是所谓的软禁. 你将被指导如何帮助预防感染, 包括洗手, 避免拥挤的人群，避免吸烟.

在BMT中获取更多关于照顾自己的信息 门诊医疗 部分的 自体移植指南.