Allogeneic Transplant

For allogeneic transplantation, 患者接受匹配的亲属供体的骨髓或血液干细胞. Identical twin allogeneic transplants are called syngeneic transplants. You will be admitted to the hospital on the day your chemotherapy begins. Your admission date may be changed based on your bed availability. The length of your admission will be about four to six weeks.

骨髓移植医生将通过回顾您的医疗记录和病史来开始评估, performing a physical exam, and discussing the procedure with you. 这次访问将是您的第一次咨询，还将包括与骨髓移植协调员的访问, who will help you through the process. 如果确定你是同种异体干细胞移植的候选人, a treatment plan will be determined.

Before being admitted to the hospital, 你将有几天的实验室和其他诊断测试来确定你的心脏功能是否正常, 肺, kidney and liver and that you do not have an undiagnosed infection. 在你入院之前，这些检查大部分都是作为门诊病人进行的. These tests may include:

• 血液测试
• Urine test and/or 24 hour collection
• Bone marrow aspiration and biopsy
• 胸部x光片
• Pulmonary function tests (PFTs)
• CAT Scans and/or PET Scan
• 超声心动图
• 牙科考试

一根叫做三腔灌注导管的软管将在麻醉下插入锁骨下的胸部大静脉. This can be either an outpatient or inpatient procedure. 插入时可能会引起一些不适，疼痛可能会持续几天. Having this catheter enables the health team to administer chemotherapy, 其他药物, blood products and even the stem cell transplant to you painlessly. 也, 该导管将用于提取治疗过程中所需的血液检测样本, thereby minimizing the need to insert needles into your arms or hands. 在一般情况下, the catheter is present throughout the hospital stay, and will be removed once you no longer need it and your counts have recovered.

Chemotherapy begins the day of admission to the hospital. 你的医生会告诉你所有的药物和它们的副作用. 您的移植协调员和住院护士将会回答您的问题. 此外，您将在同意书中收到有关这些药物的书面信息.

Precautions are taken to minimize side effects from these drugs.

一些患者在化疗的同时接受全身照射(TBI). 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通常在放射治疗部门进行，时间通常为三到四天. The treatment itself is painless, but there may be uncomfortable side effects after treatment, such as mouth and throat sores, 恶心想吐, stomach and intestinal irritations, 皮肤发红. 每次治疗前通常要服用止吐药以减轻恶心.

移植细胞或干细胞将在最后一次化疗或放射剂量后一到两天内注入. 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15-20分钟，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, 温度, 呼吸和脉搏, and will watch for any side effects. Usually there are no side effects, but occasional patients may experience chills, 脸红, 恶心和呕吐, 头疼, and changes in blood pressure and breathing. 移植后的24小时内，您的尿液也可能呈淡红色. 然而，如果你的尿液在这段时间后仍然是红色的，或者之后变得红色，告诉你的护士.

新骨髓在移植后不会立即恢复. 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 这个术语是用来描述你的新骨髓何时开始发挥作用并产生细胞吗. 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.

我们鼓励你从家里找出并带一些东西，这些东西会让你在医院里的环境更舒适. 你可以自己带舒适的衣服，比如睡衣、短裤和t恤. Using your own clothing will make it feel less like a foreign environment. After it has been worn, clothing will be given to a family member to launder.

For health reasons, no fresh flowers or live plants are allowed. If you have questions about what is appropriate to bring into the hospital, your transplant coordinator can discuss it with you. Please do not bring toilet items such as: razors and nail clippers. 这是不允许的. Electric razors are allowed. If you wear eye glasses, please bring them. Do not bring contact lenses as you will not be allowed to wear them. You may bring your own computer, 立体声, 视频游戏, 填字游戏, 书籍或其他可以让你在医院里感到舒服的东西.

A nurse will check your vital signs (温度, 脉冲, respiration and blood pressure) at intervals around the clock. 在清晨, 护士还会从你的导管中抽血，并为你量每日体重. Medications and transfusions are given throughout the day and night. Consultants' visits and tests may be done on an on-call basis. Your doctors will visit you at least once a day. 如果您或您的家人有疑问，请咨询您的住院护士，她可以联系您的协调员, physician or other member of the team to take care of your question quickly. Do not hesitate to talk with your inpatient nurse.

While you are receiving treatment, 你对感染的抵抗力很低，因此有些食物你不能吃. These include fresh fruits and vegetables. Because these foods have a high bacteria count, they are not safe to eat while your blood counts are low. Other food restrictions will be explained to you by the dietician, 谁会告诉你食物的喜好和我们厨房准备的饭菜.

你需要从床上爬起来，尽可能多地活动活动，以保持肺部和肌肉的良好状态. 除了, 每天在你的房间和大厅里走几圈，坐在椅子上也会有帮助. 然而，当你在地板上走动时，你必须戴上口罩并保持双手清洁. 病人不得离开病房，除非是为了进行医学检查或手术.

In the private rooms on the BMT unit, 探访时间不受限制，夜间可以有一名家庭成员或看护人陪伴您. 必须小心避免将传染病从来访者传染给病人. 12岁以下儿童和有感染症状的人不允许进入. No more than three visitors are allowed at a time. 游客 are required to wash their hands upon entering the room. Preparing to Leave the Hospital When your neutrophil count is over 1000, your team will finalize your discharge plan. 你需要确保在你出院后有人陪在你身边，并且有接送你去诊所的交通工具. You or a family member will learn how to care for your catheter. To be discharged, you will need to be:

• 走
• Eating at least 50% of required calories a daily
• Drinking at least one quart of fluid daily
• Free of active problems
• 不发烧
• Off intravenous medications & 服用药片
• Able to care for your catheter

Your transplant coordinator can assist with arrangements for home care. 你的移植协调员或你的医生会检查你的出院和门诊指示，并和你一起检查你的药物.