可能出现的并发症 of Autologous or 同种异体移植

可能是高剂量的化疗, 辐射, fluids or infections can affect your heart and lungs, 降低他们的功能. 出于这个原因, 你之前会有测试, during and after your transplant to monitor the condition of these organs.

You can play an important and active role in preventing lung complications. If you smoke, you must stop smoking prior to your admission for transplant. Smoking is not permitted while you are in the hospital, 移植后再次吸烟会增加严重肺部并发症的风险.

肾脏通过产生尿液来帮助维持体液的适量和特性. They also process some drugs and remove other waste products from your body. 由于移植过程的强度，出现肾脏问题并不罕见. 虽然轻微的肾脏问题是常见的，但他们被认真对待并积极治疗.

你将接受的许多化疗药物可能对你的肾脏和/或膀胱有害. This is why your kidney function is closely monitored throughout treatment.

有些药物会影响膀胱中的神经，可能会阻止你完全排空膀胱. 有时候你通过静脉注射来排出化疗药物的液体量太大了, 你会保留液体. If this occurs, you may be given a diuretic to increase your urine output.

很少, 尽管密切监测和积极治疗, kidney failure that does not respond to medications such as diuretics may occur. 在这些情况下, 可能需要透析来帮助肾脏愈合并清除体内积聚的毒素. The need for dialysis may be temporary until kidney function returns. 有时这种需要是永久的.

不孕不育 can be a devastating side effect of transplant, but not all patients undergoing a transplant will experience infertility. 不是移植本身, 但是在移植前进行的大剂量化疗和/或放疗会损害生殖细胞. 化疗可以损害或破坏卵子和精子进化的卵巢或睾丸细胞.

化疗或放疗引起的不孕症可以是暂时的，也可以是永久性的，可以在移植前低剂量或高剂量的情况下发生. 在考虑移植之前接受过标准化疗或放射治疗的患者可能已经不育. 更多信息:

• 南京生育中心

在极少数情况下, the transplanted marrow or stem cells (donor cells or even the recipients own cells) do not repopulate the recipients marrow; this is called lack of engraftment or graft failure. When this happens, patients are predisposed to infections and other complications. They may need transfusions of blood (RBCs) and platelets for support. 治疗 also can include erythropoetin and neupogen injections. Sometimes graft failure is life-long, even life threatening. 这是一种非常罕见的并发症.

偶尔, 移植并不能达到目的, and the patients disease doesnt go into remission or it comes back. 因为每个人都希望能治愈, it is natural that this outcome is devastating for the patient, 他或她的家人和移植团队.

Unfortunately, should this happen, options for cure are limited. Some treatments can still potentially cure the disease, 虽然复发性疾病更困难，发生的可能性更小.

很少，接受过化疗和/或放疗的人可能会发展成第二种新的癌症. Even though used initially to treat their cancer, these agents can possibly have long-term effects on the body.

When your doctor makes the recommendation to use these treatments, 这是因为他或她认为，不治疗疾病的风险比未来可能出现的副作用的风险更大.

继发性恶性肿瘤可能在治疗后的任何时间、患者生命中的任何时间发生.

有时候，一个病人的癌症对我们提供的所有治疗方法都有抗药性, 不管病人有多困难, 家属和移植团队尝试, 偶尔移植不起作用, or complications may arise that are insurmountable. 死亡总是一种可能.

静脉阻塞疾病, more recently renamed Sinusoidal Obstruction Syndrome (SOS), 移植前接受的高剂量化疗和/或放疗是否会导致潜在的严重肝脏问题. 在VOD患者中, the blood vessels that carry blood through the liver become swollen and obstructed. 这会损害肝脏从血液中清除废物的能力. Pressure and fluid build up in the liver, causing liver swelling and tenderness. 肾脏可能会保留多余的水和盐，导致液体在体内积聚. 腿部、手臂和腹部可能出现肿胀.

当怀疑视频点播时，团队将尝试通过以下方式防止更严重的并发症:

• 减少或停用某些药物
• 开利尿剂增加尿量，减轻组织内积液
• 透析，如有必要
• Carefully monitoring the volume of fluids in the body
• 输血填充红细胞，以保持高循环血容量，直到点播结束

Medications may be used to prevent and treat VOD.

Avascular necrosis—the loss of blood supply to the bone, 导致骨组织死亡的原因是什么?是长期使用类固醇治疗副作用的常见并发症吗. The head of the femur (thigh bone) is usually affected, but the head of the humerus (arm bone) can also be involved. 早期症状是髋关节内钝痛或压迫感，负重或髋部剧烈运动会加重, 臀部或肩膀疼痛或不适, 活动范围有限, or stiffness in the joint (contractures) should be reported to your doctor. 可能需要手术干预.

随着类固醇逐渐减少, 你可能会肌肉酸痛, 情绪变化, 嗜睡, 食欲不振，皮肤变化.

长期使用类固醇的其他副作用包括库欣样外观(月亮脸)。, 倒塌的椎骨, 骨质疏松和高血压. 下面的列表提供了有关可能出现的症状以及如何处理这些症状的更多信息:

• 太阳的敏感性. Avoid sun exposure; wear sunscreen with a high sun protection factor (SPF).
• 类固醇引起的糖尿病/血糖升高. 避免大量的浓缩糖果. 这种并发症可以通过调整饮食、口服药物以及有时使用胰岛素来治疗.
• 增加食欲. Eat a well-balanced diet, exercise as permitted, and monitor your weight.
• 情绪障碍. Expect some variations in mood, but report marked changes in your behavior.
• 身体和面部毛发增加. 这是一种常见但暂时的副作用.
• 胃溃疡. 与食物或牛奶一起服用药物, 报告胃痛, 黑大便, 吐血或腹部肿胀.
• 失眠. 在早上服用类固醇，而不是在睡前服用.

所有的捐赠者和接受者之间都有一定程度的不相容(除了同卵双胞胎的情况), 即使他们有六个匹配的HLA抗原, so GVHD is a common complication following allogeneic transplant. 这种疾病的症状从轻微到危及生命，有短期或长期的症状.

当供体免疫系统的t细胞识别出你细胞上的蛋白质(抗原)并进行攻击时，就会发生GVHD. 虽然GVHD可能产生有益的抗肿瘤作用，但过量会导致严重的问题，甚至死亡.

GVHD的发病率和严重程度各不相同, 根据供体和受体之间的差异程度和类型而定的:

• 如果六种HLA抗原都是相容的, GVHD不太可能是严重的, but not all people are able to find a donor who matches them completely.
• 更大的不相容问题出现在老年人身上，无论是作为捐赠者还是接受者.
• Because the donors T-cells recognize the recipient as foreign, 供体t细胞的数量越多, 风险越大.
• Newer drugs available today are doing a better job of preventing and treating GVHD.

These factors can affect the success of a transplant, but to a lesser degree:

• If the donor and recipient are the same gender (Males have X and Y chromosomes, 雌性有X和X).
• 如果捐赠者是女性，她怀孕的次数(越少越好).
• If the recipients conditioning regimen includes TBI (total body ir辐射).

GVHD可分为急性或慢性. 患者可能没有经历过，也可能经历过一种或两种. Acute GVHD occurs within the first 100 days or so following allogeneic BMT, and chronic GVHD occurs after the first 100 days. Day 100 should be considered merely a guideline, however.

The first sign of acute GVHD is usually a mild skin rash. 这可能会变成类似晒伤的红色. 在更严重的情况下，皮肤可能会起泡或剥落. Acute GVHD can also affect the gastrointestinal tract and liver. 一些恶心的组合, 抽筋, 带血或水样腹泻和黄疸, 发黄皮肤和眼睛发黄, 可能导致.

病人 who have had acute GVHD are at greatest risk for developing chronic GVHD. 然而, a patient who has not had acute GVHD can still have chronic GVHD, 在BMT后三个月或更长时间出现的症状. 皮肤问题，包括皮疹，瘙痒，皮肤颜色的变化，病变和紧绷是典型的.

Other common symptoms are liver abnormalities and infections. 慢性GVHD会攻击腺体，导致眼睛干燥或灼烧，口腔干燥或灼烧和口腔溃疡. Good oral hygiene is crucial to minimize infections.

肠胃不适会使营养难以正常吸收，并导致吞咽困难, 胃灼热, 胃痛和体重减轻. 有时, 慢性GVHD会导致皮肤疤痕, 头发过早变白, 脱发, 视力问题, 肝损伤和, 偶尔, 关节肌腱的收紧，使胳膊和腿的活动变得困难.

症状可以从轻微到严重. 它们可以单独发生，也可以一起发生.

Prior to your transplant, you will receive drugs to prevent infection and GVHD. It is imperative that you practice good hygiene throughout the transplant process.

The most common agents used to prevent GVHD are cyclosporine, 他克莫司(fk - 506队/ Prograf), 甲氨蝶呤和类固醇. Some form of prevention is always started before allogeneic transplant. 在没有通知医生或移植协调员的情况下，服用抗移植物抗宿主病药物是至关重要的.

Coping with GVHD can be very challenging for patients and their families. You may be angry that you must deal with this illness on top of everything else. Drugs you are taking may exaggerate mood swings, depression and anxiety. Please try to keep in mind that GVHDs manifestations are temporary.