Imiphumela ye-Chemotherapy eyenziwe yi-Myelosuppression
Incazelo
Ukuxoshwa kwe-Myelosuppression kuchazwa njengokunciphisa ikhono lomnkantso wesifuba ukukhiqiza amaseli egazi. Kwenzeka kakhulu kaningi ngomdlavuza njengomphumela ohlangothini lwe-chemotherapy , kodwa kunezinye izimbangela.
Amaseli Athintekayo eMyelosuppression
Ukuxoshwa komzimba kungaholela ekunciphiseni ukukhiqizwa kwe:
- Amaseli aphuzi egazi (ama-RBC)
- Amaseli amhlophe egazi (WBCs)
- Platelets
I-Hematopoiesis, i-Bone Marrow, ne-Myelosuppression
Ukuqonda ukukhulelwa komzimba kuyasiza ukukhuluma ngomsebenzi wamathambo. Emnothweni wamathambo, wonke amaseli egazi-amangqamuzana egazi abomvu, amaseli egazi amhlophe, namaplatelet-aqala ngohlobo olulodwa lweseli: i- hematopoietic stem cell .
Ama-stem ama-Hematopoietic anekhono lokuguqula kunoma yiluphi uhlobo lwegazi leseli. Lawa maseli awela emigwaqeni ehlukene njengoba ehlukanisa amangqamuzana egazi abomvu, amaplatelets, namaseli amhlophe egazi, bese efika amangqamuzana akhethekile afana nezinhlobo ezahlukene zamangqamuzana egazi elimhlophe. Kodwa zonke ziqala ngama-stem cells. Ukuxoshwa komzimba kubhekisela enkambisweni ephazamisa lawa maseli, futhi. ngenxa yalokho, kuthinta zonke izinhlobo ezahlukene zamaseli egazi. Igama elithi myeloablation libhekisela ekukhulisweni okunamandla okungekho amangqamuzana egazi akwenziwa.
Izimbangela
Kunezindlela eziningana lapho umnkantsha wethambo ungaphazanyiswa ukuze ungavelisi amaseli egazi.
- Ukulimala kwamangqamuzana e-stem - Isizathu esivame kakhulu sokukhulelwa kwesisu ngenxa yemithi ephuza ikhono lama-stem cells kanye nezinzalo ezikhethekile ukuhlukanisa nokwanda. Wonke amangqamuzana ethu egazi aqhubeka egcwaliswa. Imithi efana nezidakamizwa ze-chemotherapy idala ukucindezelwa komnyofu we-bone-induced.
- Ukuguquka komnyobo / ukuqhuma - Umnkantsha we-bone ungase ube "uphelelwe ngaphandle" ngezinto ezinjengama-khansela egazi noma umdlavuza we-metastatic ukuze kungabi "igumbi" lokukhiqiza okwejwayelekile kwamaseli egazi.
- Ukungaphumeleli komnyobo we-bone - Esikhundleni sokucindezelwa yimithi, umnkantsha wamathambo ungakwazi ukubhujiswa yizinto ezinobuthi namakhemikhali ahlukahlukene. Uma kunjalo, ukumisa lesi sidakamizwa ngeke kuholele emnothweni wethambo futhi wenze umsebenzi walo wokukhiqiza amangqamuzana egazi.
Izimbangela Eziqondile Ze-Myelosuppression
Izinqubo ezingabangela ukuguqulwa kwe-myelosuppression kufaka:
- Ukususwa komnyofu we-bone okwelashwa kwe-Chemotherapy . I-Chemotherapy ibulala wonke amangqamuzana ahlukanisa ngokushesha njengama-cancer amangqamuzana, kuhlanganise namaseli abe yiwo wonke izinhlobo zamaseli egazi.
- Amakhansela emnkantsheni wamathambo njengama-leukemi, i-lymphomas, i-myeloma, umdlavuza we-metastatic emnothweni wamathambo angabangela "ukuqhuma" ngakho-ke akukho ndawo yokuba i-hematopoiesis yenzeke.
- Ukuxoshwa kwesisu / isilonda - Ngama-cancer ahlobene negazi akhona emnothweni wamathambo, i-chemotherapy ephakeme kakhulu isetshenziselwa ukuqeda umthambo wethambo. Uma umnkantsha we-bone "ucacile" ukufakelwa komnyoba wamathambo noma ukuguqulwa kwegazi kwe-stem cell kwenziwa ngaleso sikhathi ukuphinda ukhiphe umnkantso wamathambo ngamaseli angama-blood stem.
Ukwehluleka kwamaseli egazi
Lapho amangqamuzana amancane angakhuli futhi ahlukanise futhi ahlolisise izinhlobo ezihlukile zamangqamuzana egazi (uma kunomthelela we-bone lomnkantso noma umlenze we-myelosuppression) ohlobo lwamaseli egazi abizwa ngokuthi:
- I-anemia - i-anemia ibhekisela ekuntulekeni kwamaseli abomvu obomvu. I-anemia ingabangela ukukhathala, ubuthakathaka, ubuhlungu, ukushaya kwenhliziyo okusheshayo, ukuphefumula nokuphefumula. I-anemia eyenziwa yi-chemotherapy yimbangela evamile yokukhathala ngesikhathi samakhemikhali.
- I-Leukopenia - i-Leukopenia ibhekisela ekuntulekeni kwegazi elimhlophe. Abantu abane-leukopenia bafaka ingozi yokutheleleka, ngakho-ke izimpawu zingase zibe izimpawu zezifo ezifana nomkhuhlane, ukukhwehlela, nobuhlungu ngokuchama. Ngomdlavuza, ngokuvamile abantu bazozwa nge -neutropenia eyenziwa yi-chemotherapy . I-neutrophils yimihlobo yegazi elimhlophe eliwumzila wokuqala wokuzivikela futhi izifo ezinama-bacterium, amagciwane, kanye nesibungulu (futhi ngokumelene namangqamuzana omdlavuza).
- I-Thrombocytopenia - I-Thrombocytopenia ibhekisela ekusileni kwamaplatelet. Izinga eliphansi lamaplatelet lingabangela ukulimaza nokugaya okukhulu. I-thrombocytopenia eyenziwa yi-chemotherapy ingase ingabi inkinga kaningi njengokuthi i-neutropenia kodwa ingabangela ukugaya okukhulu kwabanye abantu.
Ingabe i-Myelosuppression efanayo ne-Immunosuppression?
Ungase uzibuze ukuthi ukuzivivinya nokuguliswa kwesisu kufana yini. Ekusetshenzisweni kwe-myelosuppression, ukukhiqizwa kwamangqamuzana egazi omhlophe kuncipha, ngakho-ke kuyoba nokuzivikela komzimba. Kodwa ukuzivivinya umzimba akusho ngaso sonke isikhathi ukuguqulwa komzimba. Isibonelo, imithi (noma enye inqubo) inganciphisa amaseli egazi amhlophe noma ezinye izingxenye ezithile zesistimu yomzimba, kodwa zingathinti amangqamuzana egazi abomvu noma amaplatelet.
Ukwelapha
Ukwelashwa kwe-myelosuppression kuzobandakanya ukwelapha noma yikuphi okubangela ukukhishwa kwesisu. Uma ihlobene nezidakamizwa noma i-chemotherapy, ukwelashwa kungadingeka kumiswe noma kuphuze. Uma kungenxa yokungena kwamathambo, futhi ukuqhuma okuqhubekayo, ukwelashwa komdlavuza emnothweni wethambo kuyisinyathelo esibaluleke kakhulu. Uma kungenxa yokwehluleka kweminwe, kuyoba kubalulekile ukubona ukuthi ukuhluleka komnkantsha we-bone kungabuyiselwa yini, noma uma kungenjalo, ukwelashwa okufana nokuguqulwa kwamaseli egazi kanye nokufakelwa komnkantsha wamathambo kungahle kudingeke kucatshangelwe.
Ukuze uthole izimpawu ezihlobene nokuxoshwa kwemithi, ukwelashwa kungase kuqondiswe ekuthelekeni kwesisindo esithile esibangela izimpawu. Ukuze kutholakale i-anemia, ukumpontshelwa igazi, izithako zensimbi, noma izici zokukhula zinganikezwa. Ngenxa ye-neutropenia eholela engozini yokutheleleka noma ukutholakala kwesifo, izici zokukhula (njenge-Neulasta) zingase zisetshenziswe futhi ukutheleleka kuphathwa kabi ngokuhlanganiswa kwama-antibiotic. Izinga eliphansi lamaplatelet eliphakamisa ingozi yokumpontshelwa igazi kungadingeka.
Izixhumanisi ezingaphezulu ngenhloso yokwelapha i-chemotherapy-induced anemia, neutropenia, kanye ne-thrombocytopenia zichazwe lezi zindlela zokwelapha ezingacatshangwa uma ukuguqulwa kwesisu kuhlobene ne-chemotherapy.
Futhi eyaziwa ngokuthi: Ukunciphisa umnyo we-Bone
Izibonelo: Ngenxa yokucindezeleka okukhulu, uRick's oncologist wancoma ukuthi alinde ngesonto ngaphambi kokwelapha kwakhe okwelashwa kwamakhemikhali.
> Imithombo:
> Coates, T., i-Neutropenia edla izidakamizwa kanye ne-Agranulocytosis. UpToDate . Kubuyekezwe 08/01/16.
> Weinzierl, E., no D. Arber. Ukuhlonza okuhlukile kanye ne-Bone Marrow Ukuhlola kwe-New-Onset-Pancytopnia. I-American Journal of Clinical Pathology . 2013. 139 (1): 9-29.