tailieunhanh - Hanbook of pediatric transfusion medicine - part 8

HPC thường được quản lý bệnh nhân có của hệ thống tạo máu là khiếm khuyết. Mặc dù bệnh có thể trực tiếp gây ra các khiếm khuyết BM, điều trị ung thư độc hại là nguyên nhân thường xuyên hơn của các thiệt hại BM. Cấy ghép tế bào gốc tạo máu đã được sử dụng cho các suy giảm miễn dịch | 23. Bone Marrow-Derived Stem Cells 277 negative BM have developed anti-D antibodies. While these patients RBCs may undergo increased hemolysis Rh-negative RBCs should repopulate their circulatory systems as the donor BMs engraft. Ordering and Administration When considering an allogeneic BM-HPC transplant a donor with a compatible HLA type must be identified. Family members especially siblings are usually the best potential donors and their HLA types are determined. If no donor is identified in the patient s family searches for potential donors can be made through national and international BM transplant registries. High-resolution HLA types of potential donors are determined to identify histocompatible donors. If a compatible donor is identified his or her health status is assessed. Autologous BM-HPCs and autologous PB-HPCs are ordered and administered the same way see Chapter 24 . If an allogeneic BM transplant is planned efforts must be coordinated between the processing laboratory the physicians harvesting the BM the patient and the donor. This is made even more complex if the donation is made at a location that is different from the patient s location. In those cases the BM is harvested at a hospital that serves as the collection facility and a courier often a member of the transplant team from the patient s hospital transports the BM to the patient s hospital. Before administration of the marrow proper identification of the patient and product is critical to ensure that the patient is receiving the correct BM-HPCs. Cells are usually infused at least 24 hours after completion of chemotherapy to prevent the cytotoxic effects of chemotherapy from damaging the infused cells. Cells can be immediately infused following radiotherapy however. The patient should be well hydrated before infusion. Oxygen and anti-anaphylaxis treatment such as epinephrine should be available. Allogeneic BM-HPCs that had been cryopreserved are administered using procedures that are .