Advances in the treatment of cancer 和 improvements in supportive care over the past 10 years have improved the results 和 tolerability of stem cell transplants. However, a stem cell transplant remains an involved 和 potentially dangerous procedure. 自体移植, the patient receives his or her own bone marrow or stem cells that were collected 和 frozen before admission for high-dose chemotherapy or radiation.
A stem cell transplant specialist will begin the evaluation by reviewing your medical record 和 history, 给你做个身体检查，和你讨论手术过程. If your doctor decides that you are a c和idate for an autologous stem cell transplant, 他或她会推荐一个治疗方案.
在被送入利来登录之前, you will have several days of laboratory 和 other diagnostic tests to determine if you have normal function of the heart, 肺, 肾和肝，你没有未确诊的感染. Most of these tests will be done as an outpatient before you are admitted to the hospital, 但是其他的可能需要在你入院治疗后完成. 这些测试可能包括:
Stem cells are found predominantly in the bone marrow but can be stimulated to travel out into the blood. 当干细胞通过许多骨髓从髋骨中收集时, 哪些手术通常在手术室进行, 这种移植过程被称为骨髓移植. 现在很少有人这样做了. When the stem cells are collected from the blood after stimulating the stem cells with a hormone called G-CSF, 或者一种叫做prelixafor的新药, 这种移植被称为外周血干细胞移植. Currently, most transplant procedures involve collecting stem cells from the peripheral blood.
当骨髓或血液干细胞被注入病人体内时, they are administered through an intravenous catheter (IV) or central venous catheter, 就像输血一样. 干细胞并没有直接注入到骨头中, 而是从血液流向骨骼.
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.
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.
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.
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.
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:
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.
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.
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.
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.
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 和 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.