Ukutshintshwa kweMarrow Marrow

Umxholo

• Kutheni le nto unokufuna ukuTshintshwa kweMarrow Bone
• Zithini iingxaki ezinxulumene nokuTshintshwa kweMarrow yeT Bone?
• Iindidi zokuTshintshwa kweMarrow Bone
• Utyando lwe-Autologous
• Ukutshintshwa kweAllogeneic
• Uyilungiselela njani iTransplant Marrow
• Wenziwa njani uTshintsho loMongo wethambo
• Leukapheresis
• Yintoni ongayilindela emva kokuTshintshwa kweMarrow Marrow

Yintoni iTransplant Marrow Transplant?

Ukufakelwa komongo wethambo yinkqubo yonyango eyenziwayo yokutshintsha umongo wethambo owonakalisiweyo okanye owonakaliswe zizifo, usulelo okanye ichemotherapy. Le nkqubo ibandakanya ukufakelwa kweeseli zegazi, ezihamba ziye kumongo wethambo apho zivelisa khona iiseli ezintsha zegazi kunye nokukhuthaza ukukhula komongo omtsha.

Umongo wethambo sisiponji, izicwili ezinamanqatha ngaphakathi kwamathambo akho. Yenza ezi ndawo zilandelayo zegazi:

• iiseli ezibomvu zegazi, ezithwala ioksijini kunye nezondlo emzimbeni wonke
• iiseli ezimhlophe zegazi, ezilwa nosulelo
• iiplatelets, ezinoxanduva lokwenziwa kwamahlwili

Umongo wethambo uqulethe neeseli ezinamagazi ezingafakwanga ezibizwa ngokuba ziiseli zehematopoietic stem, okanye iiHSCs. Uninzi lweeseli sele zahlulwe kwaye zinokwenza iikopi zazo kuphela. Nangona kunjalo, ezi seli ze-stem azibalulekanga, oko kuthetha ukuba zinakho ukuphindaphindeka ngokwahlula-hlula iiseli kwaye zihlala ziiseli ze-stem okanye zahlule kwaye zivuthwe kwiindidi ezahlukeneyo zeeseli zegazi. I-HSC efunyenwe kumongo wethambo iya kwenza iiseli ezintsha zegazi ngalo lonke ixesha lokuphila kwakho.

Ukufakelwa komongo wethambo endaweni yeeseli zakho ezonakalisiweyo kunye neeseli ezisempilweni. Oku kunceda umzimba wakho wenze iiseli ezimhlophe zegazi ezaneleyo, iiplatelets, okanye iiseli ezibomvu zegazi ukunqanda ukusuleleka, ukuphazamiseka kwegazi, okanye i-anemia.

Iiseli ezinesiqu ezisempilweni zivela kumnikeli, okanye zinokuvela emzimbeni wakho. Kwiimeko ezinjalo, iiseli zeziqu zinokuvunwa, okanye zikhule, ngaphambi kokuba uqale unyango ngamayeza okanye ngemitha. Ezo seli ziphilileyo zigcinwa kwaye zisetyenziselwe ukufakelwa.

Kutheni le nto unokufuna ukuTshintshwa kweMarrow Bone

Ukufakelwa komongo wethambo kwenziwa xa umongo womntu ungekho sempilweni ngokwaneleyo ukuba usebenze ngokufanelekileyo. Oku kunokuba ngenxa yosulelo olungapheliyo, isifo, okanye unyango lomhlaza. Ezinye izizathu zokutsalwa komongo wethambo zibandakanya:

• i-aplastic anemia, esisifo apho umongo uyeka ukwenza iiseli ezintsha zegazi
• Iicancer ezichaphazela umongo, njenge-leukemia, i-lymphoma kunye ne-myeloma eninzi
• Umongo wethambo owonakeleyo ngenxa yekhemotherapy
• i-neutropenia yokuzalwa, esisifo esizuze ilifa esibangela ukosuleleka okuphindaphindayo
• I-sickle cell anemia, sisifo segazi esizuzwe njengelifa ebangela ukuba kubumbeke iiseli ezibomvu zegazi
• i-thalassemia, sisifo segazi esizuzwe njengelifa apho umzimba wenza uhlobo olungaqhelekanga lwehemoglobin, eyinxalenye yeeseli ezibomvu zegazi.

Zithini iingxaki ezinxulumene nokuTshintshwa kweMarrow yeT Bone?

Ukufakelwa komongo wethambo kuthathwa njengenkqubo enkulu yonyango kwaye kwandisa umngcipheko wokufumana:

• ukwehla koxinzelelo lwegazi
• intloko ebuhlungu
• isicaphucaphu
• intlungu
• ukuqhawukelwa ngumphefumlo
• Ukugodola
• umkhuhlane

Ezi mpawu zingasentla zihlala ixesha elifutshane, kodwa ukufakelwa umongo wethambo kunokubangela iingxaki. Amathuba akho okuphuhlisa ezi ngxaki axhomekeke kwizinto ezininzi, kubandakanya:

• iminyaka yakho
• impilo yakho iyonke
• isifo osinyangayo
• uhlobo lofakelo olufunyenweyo

Iingxaki zinokuba nokuthamba okanye kakhulu, kwaye zinokubandakanya:

• isifo se-graft-versus-host (GVHD), imeko apho iiseli zabanikeli zihlasela umzimba wakho
• ukusilela kokumiliselwa, okwenzeka xa iiseli ezifakelweyo zingaqali ukuvelisa iiseli ezintsha njengoko bekucwangcisiwe
• ukopha emiphungeni, kwingqondo nakwezinye iindawo zomzimba
• I-cataract, ebonakaliswa kukugubungela kwiliso leliso
• umonakalo kwizitho ezibalulekileyo
• ukuya exesheni kwangoko
• ianemia, eyenzeka xa umzimba ungavelisi iiseli ezibomvu zegazi ezaneleyo
• usulelo
• isicaphucaphu, urhudo, okanye ukugabha
• I-mucositis, yimeko ebangela ukudumba kunye nokuqaqamba emlonyeni, emqaleni, nasesiswini

Thetha nogqirha wakho malunga nayiphi na inkxalabo onokuba nayo. Banokukunceda ulinganise umngcipheko kunye neengxaki ngokuchasene nezibonelelo ezinokubakho zale nkqubo.

Iindidi zokuTshintshwa kweMarrow Bone

Zimbini iintlobo eziphambili zokufakelwa komongo wethambo. Uhlobo olusetyenzisiweyo luya kuxhomekeka kwisizathu sokuba ufuna ukufakelwa.

Utyando lwe-Autologous

Ukufakelwa kwe-Autologous kubandakanya ukusetyenziswa kweeseli zomntu. Ngokuqhelekileyo kubandakanya ukuvuna iiseli zakho ngaphambi kokuba uqale unyango olonakalisayo kwiiseli ezinjenge-chemotherapy okanye i-radiation. Emva kokuba unyango lwenziwe, iiseli zakho zibuyiselwa emzimbeni wakho.

Olu hlobo lokufakelwa akusoloko lufumaneka. Inokusetyenziswa kuphela ukuba unomongo wethambo osempilweni.Nangona kunjalo, kunciphisa umngcipheko weengxaki ezinzulu, kubandakanya i-GVHD.

Ukutshintshwa kweAllogeneic

Utshintsho olwenziwe ngeAllogeneic lubandakanya ukusetyenziswa kweeseli ezivela kumnikeli. Umnikeli kufuneka abe ngumdlalo osondeleyo wemfuzo. Rhoqo, isihlobo esihambelanayo lolona khetho lukhethekileyo, kodwa umdlalo wezofuzo unokufumaneka kwirejista yabanikeli.

Ukufakelwa kweAllogeneic kuyafuneka ukuba unemeko eyonakalise iiseli zomongo wethambo. Nangona kunjalo, banomngcipheko ophezulu weengxaki ezithile, ezinje nge-GVHD. Kananjalo kuya kufuneka ukuba ubekwe kunyango ukuze ucinezele amajoni akho omzimba ukuze umzimba wakho ungahlaseli iiseli ezintsha. Oku kunokukushiya usengozini yokugula.

Impumelelo yokufakelwa kwe-allogeneic kuxhomekeke kwindlela iiseli zabanikeli ezihambelana ngayo.

Uyilungiselela njani iTransplant Marrow

Ngaphambi kofakelo lwakho, uya kuvavanywa kaninzi ukuze ufumanise ukuba loluphi uhlobo lweeseli zomongo wethambo ozifunayo.

Unokwenza i-radiation okanye i-chemotherapy ukubulala zonke iiseli zomhlaza okanye iiseli zomongo ngaphambi kokuba ufumane iiseli ezintsha.

Ukutshintshwa komongo wethambo kuthatha iveki. Ke ngoko, kuya kufuneka wenze amalungiselelo ngaphambi kweseshoni yakho yokuqala yokufaka. Oku kunokubandakanya:

• izindlu ezikufutshane nesibhedlele sabathandekayo bakho
• inshorensi, ukuhlawula amatyala, kunye nezinye izinto ezixhalabisa imali
• ukhathalelo lwabantwana okanye izilwanyana zasekhaya
• ukuthatha ikhefu emsebenzini
• ukupakisha iimpahla nezinye izinto eziyimfuneko
• ulungiselela ukuhamba ukuya nokubuya esibhedlele

Ngexesha lonyango, amajoni akho omzimba aya kuthintelwa, echaphazela ukubanakho ukulwa nosulelo. Ke ngoko, uya kuhlala kwicandelo elikhethekileyo lesibhedlele eligcinelwe abantu abafumana utyando lomongo wethambo. Oku kunciphisa umngcipheko wokuvezwa kuyo nayiphi na into enokubangela usulelo.

Unganqikazi ukuzisa uluhlu lwemibuzo ukubuza ugqirha wakho. Ungabhala phantsi iimpendulo okanye uzise umhlobo ukuba amamele kwaye athathe amanqaku. Kubalulekile ukuba uzive ukhululekile kwaye uqinisekile ngaphambi kwenkqubo kwaye yonke imibuzo yakho iphendulwe kakuhle.

Ezinye izibhedlele zinabacebisi abakhoyo ukuze bathethe nezigulana. Inkqubo yokufakelwa inokuthi ibe yirhafu ngokweemvakalelo. Ukuthetha nengcali kunokukunceda kule nkqubo.

Wenziwa njani uTshintsho loMongo wethambo

Xa ugqirha wakho ecinga ukuba ulungile, uya kufakelwa. Inkqubo iyafana notofelo-gazi.

Ukuba unokufakelwa kwe-allogeneic, iiseli zomongo wethambo ziya kuvunwa kumnikeli wakho ngosuku okanye ezimbini ngaphambi kwenkqubo yakho. Ukuba iiseli zakho ziyasetyenziswa, ziya kugqitywa kwi-stem cell bank.

Iiseli ziqokelelwa ngeendlela ezimbini.

Ngexesha lokuvuna umongo wethambo, iiseli ziqokelelwa kuwo omabini amathambo ngenaliti. Ungaphantsi kweanesthesia yale nkqubo, oko kuthetha ukuba uyakulala kwaye ukhululeke kuyo nayiphi na intlungu.

Leukapheresis

Ngexesha leukapheresis, umnikeli unikwa izithonga ezintlanu ukunceda iiseli zeziqu zihambe zisuka kumongo wethambo ziye kwigazi. Igazi ke litsalwa ngomgca we-intravenous (IV), kwaye umatshini wahlula iiseli ezimhlophe zegazi ezineeseli zeziqu.

Inaliti ebizwa ngokuba yi-central venous catheter, okanye izibuko, iya kufakwa kwicandelo elingaphezulu lasekunene kwesifuba sakho. Oku kuvumela ukuba ulwelo oluqulathe iiseli zeziqu ezitsha ukuba zihambe ngqo ziye entliziyweni yakho. Iiseli zeziqu zisasazeka emzimbeni wakho wonke. Zihamba ngegazi lakho kunye nomongo wethambo. Ziya kusekwa apho kwaye ziqale ukukhula.

Izibuko lishiywe endaweni yokuba ukufakelwa komongo wethambo kwenziwa kwiiseshoni ezininzi kwiintsuku ezimbalwa. Iiseshoni ezininzi zinika iiseli ezintsha zeziqu elona thuba lihle lokuzibandakanya emzimbeni wakho. Le nkqubo yaziwa ngokuba yi-engraftment.

Ngale port, uyakufumana utofelo-gazi, ulwelo, kunye nezinongo. Unokufuna amayeza ukuze ulwe nosulelo kwaye uncede ukukhula komongo omtsha. Oku kuxhomekeke kwindlela ophatha ngayo unyango.

Ngeli xesha, uya kujongwa ngononophelo kuyo nayiphi na ingxaki.

Yintoni ongayilindela emva kokuTshintshwa kweMarrow Marrow

Impumelelo yokufakelwa komongo wethambo ikakhulu ixhomekeke kwindlela omnike ngayo kunye nomamkeli ngokwemfuzo. Ngamanye amaxesha, kunokuba nzima kakhulu ukufumana umdlalo olungileyo phakathi kwabaxhasi abangadibaniyo.

Imeko yokuxhonywa kwakho iya kujongwa rhoqo. Igqityiwe ngokubanzi phakathi kweentsuku ezili-10 ukuya kwezingama-28 emva kokufakelwa kokuqala. Umqondiso wokuqala wokufakelwa kukwanda kwenani leeseli ezimhlophe zegazi. Oku kubonisa ukuba ukufakelwa kuyaqala ukwenza iiseli ezintsha zegazi.

Ixesha eliqhelekileyo lokufumana kwakhona umongo wethambo malunga neenyanga ezintathu. Nangona kunjalo, kunokuthatha ukuya kunyaka ukuba uchache ngokupheleleyo. Ukubuyisela kwimeko yesiqhelo kuxhomekeke kwizinto ezininzi, kubandakanya:

• imeko inyangwa
• ichemotherapy
• imitha
• Umdlalo womnikeli
• apho ukufakelwa kwenziwa

Kukho amathuba okuba ezinye zeempawu ohlangabezana nazo emva kokufakelwa ziya kuhlala zikunye nawe ubomi bakho bonke.