自体移植指南:血液计数 & 输血
等待移植
High doses of chemotherapy or radiation cause the bone marrow to stop producing new blood cells. The new bone marrow does not recover immediately after it has been transplanted. 移植骨髓的细胞会进入骨骼, reseed the marrow space and go through a growth process before the mature cells are released from the bone marrow into the blood stream. It will take at least eight to 14 days from the day of transplantation before your blood counts start to recover.
The term "blood counts" refers to the number of blood cells circulating in the blood stream. There are three main types of blood cells: red blood cells, white blood cells and platelets. While the bone marrow is still growing, these cells will need to be replaced through transfusions.
移植 is the term used to describe when your new marrow begins to function and produce cells. While awaiting engraftment, no mature cells leave the marrow and enter the blood stream. Your blood counts will show very low values and you will require careful monitoring by the health care team. The goal is to support you with red blood cell and platelet transfusions until you are producing cells again.
移植后, 你会得到骨髓生长因子, 所谓的g - csf, 什么会帮助骨髓细胞生长和成熟. 生长因子每天在皮下注射.
血细胞的种类
白细胞(WBCs)
白细胞对抗感染. 它们包括中性粒细胞和淋巴细胞等.
中性粒细胞, also known as polys or granulocytes, account for the majority of circulating WBCs. They are responsible for fighting primarily bacterial and fungal infections. Bone marrow growth factors like G-CSF (also called neupogen) make neutrophil counts rise. The neutrophil count should be at least 500 (usually reported on the lab test results as 0.5)移植后30天.
除非在特殊情况下,一般不输注中性粒细胞. The use of antibiotics to fight infection and growth factors to help the bone marrow grow are usually adequate until the neutrophil count is up.
淋巴细胞 是免疫系统的支柱吗. These cells are responsible for fighting viruses and for forming antibodies that will attack infectious organisms. Lymphocyte function is generally abnormal for as long as three months after transplantation. This means you may develop severe infections even when the white blood cell count is normal.
红细胞(rbc)
红细胞将氧气输送到全身. 红细胞比容是指血液中含有红细胞的百分比. 血红蛋白是红细胞中携带氧气的部分. 血红蛋白与红细胞压积成正比.
当体内没有足够的红细胞时,就会发生贫血. Symptoms include shortness of breath, weakness, fatigue, dizziness, headache and irritability. A red cell transfusion is given through your catheter over an average of two to three hours. 门诊病人可能需要额外输血, 或者给予促红细胞生成素(Epo), 红血球生长因子.
Platelets
血小板有助于控制出血. When you cut yourself, the platelets form a clot or plug to stop the bleeding. Some symptoms of a low platelet count include petechiae (small red dots on the skin), 容易擦伤, 牙龈或鼻子出血.
血小板输血
A platelet transfusion is given routinely when the platelet count falls too low to prevent serious bleeding into the tissues. You will begin to need platelet transfusions about one week after the start of chemotherapy. The number of transfusions needed per week varies from patient to patient and ranges from one to seven transfusions per week.
你还需要输三到六周的血小板, 有时长, depending on how your bone marrow is recovering or what medications you are receiving.
输注血小板有两种:
单供体血小板输注
These use platelets that are collected from one person in a procedure called apheresis, 这大概需要两到两个半小时. 在这个过程中, blood is taken from the donor and circulated through a machine called a blood cell separator. This machine separates the platelets into a collection bag and returns the remaining blood constituents to the donor.
大多数单一供体血小板来自患者的家人和朋友. 你的血小板捐赠者不需要是你的血型. You will not receive platelets from your designated donor if a more compatible single donor unit is available.
随机供体血小板输注
These use platelets that are pooled from several units of whole blood donated by several different random blood donors. 这是输注血小板最常见的类型.
潜在的血小板捐献者必须在捐献前通过初步测试, 其中包括书面历史形式, 检查生命体征,取一点血样. All persons donating blood are carefully screened for infectious diseases to make sure their blood is safe.
输血反应
You may sometimes experience an uncomfortable reaction to your blood product transfusions. Some of these reactions may include fever, chills, shaking, itching and skin rashes. 罕见的副作用是背部疼痛和呼吸短促. If you have side effects, medications are available to limit the reactions.
红血球和血小板经过辐射和过滤, and frequently medications may be used before the transfusion to minimize any side effects. 你的护士会仔细观察这些反应, 你也应该向你的护士报告任何症状.
捐献血液制品
It is helpful if you arrange to have family members donate blood products for you to use during your hospitalization. Anyone can be a blood donor as long as they complete the blood bank screening procedures and pass all the tests.
Donations can be given at any donor center; however only donations given at Blood Banks of the Pacific in San Francisco will be available for you during your hospitalization.
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加州大学旧金山分校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.