Inqubo, Inhloso, Nezinkinga Zama-PBSCT
Sibutsetelo se-PBSCT
I-Peripheral blood stem cell transplants, noma i-PBSCT, yizinqubo ezibuyisela amangqamuzana e-stem aye abhujiswe ngamanani aphezulu we-chemotherapy. Amangqamuzana omzimba amangqamuzana avumela amangqamuzana egazi - amangqamuzana egazi abomvu athatha i-oksijeni, amaseli egazi amhlophe asiza umzimba ukuba ulwe nezifo, namaplatelet ezisiza ukuba igazi liguqulwe.
Kwakuvame ukuba ukuthi ukuguqulwa kwe-stem cell kwavela emnikelweni wethambo . Nakuba iningi lamaseli e-stem ekhona emnothweni wezintambo, amanye aphuma ejikelezayo - emsakazweni wegazi we- peripheral . Lezi zingaqoqwa futhi zihanjiswe ezigulini ukubuyisela ukugcinwa kwesitoreji sabo se-stem. Iningi le-stem cell transplants (kodwa hhayi zonke ngezizathu eziningi) manje liyi-PBSCT. Ngaphambi kokunikeza amangqamuzana amancane, abanikeli banikezwa imithi ekhulisa inani lama-stem cells egazini. Ama-cell stem ama-blood stem asebenza kahle uma kuqhathaniswa nokuguqulwa kwamathambo, futhi eqinisweni, kwezinye izimo kungase kuholele amapulethi kanye nohlobo lwamaseli amhlophe egazi abizwa ngokuthi i-neutrophils "ethatha" kangcono nakakhulu, uma umnikeli engahlobene nomamukeli .
Inhloso Yezinguquko Zezingqimba ZeStem
Ukuze uqonde ukuthi ama-stem cell transplants asebenza kanjani, angasiza ukukhuluma kancane ngokuthi yiliphi amangqamuzana aqinile.
Njengoba kuphawuliwe ngenhla, ama-stem cells - awaziwa nangokuthi amangqamuzana e-hematopoietic stem - aphakamisa zonke izinhlobo ezahlukene zamaseli egazi emzimbeni. Ngokufakelwa kabusha amangqamuzana e-stem angase ahlukanise futhi aguquke ezinhlobonhlobo zamaseli egazi - inqubo okuthiwa i-hematopoiesis - ukufakelwa kungashintsha ukungabi khona kwazo zonke izinhlobo zamangqamuzana egazi.
Ngokuphambene nalokho, ukwelashwa kwezokwelapha ukubuyisela wonke lawa maseli kunzima futhi kuthwale izinkinga eziningi. Isibonelo, unganika ukuphasiswa kweplatelet, ukumpontshelwa kwegazi okubomvu, futhi unike imithi yokuvuselela kokubili ukubunjwa kwamaseli abomvu wegazi namaseli amhlophe egazi, kodwa lokhu kunzima kakhulu, kunzima, futhi kunemiphumela emibi kakhulu nezinkinga.
Izizathu zePBSCT
I-Chemotherapy ehlinzekwa ngamazinga aphezulu ibulala umdlavuza kangcono, kodwa futhi ibhubhisa amangqamuzana amancane avela emnothweni wethambo. Ama-transplant cell transplants asiza ukubuyisela umongo we-bone ukuze isiguli sikwazi ukubekezelela izinga eliphezulu le-chemotherapy.
Izinhlobo
Kunezinhlobo ezintathu ze-stem cell transplant:
- Ukuguquka kwe-Autologous: lapho iziguli zithola amangqamuzana azo.
- Ukuguquka kwe-allogeneic: lapho iziguli zithola amangqamuzana amancane avela kumfowabo, udadewabo noma umzali. I-donor engahlangani nayo ingasetshenziswa.
- Ama-Syngeneic transplants: lapho iziguli zithola amangqamuzana e-stem avela emawele awo afanayo.
Ukunikela Amakhemikhali Egazi Amaphesenti Aphephile
Iminikelo ye-PBSC ihilela ukuthatha ama-cell stem cells, kunokuba amangqamuzana avela emnothweni wamathambo, ngakho-ke akukho buhlungu bokufinyelela emnothweni wethambo. Kodwa ku-PBSC, imithi ehlinzekwa ukukhulisa inani lama-stem cells ekusakazeni komnikeli kungase ihlotshaniswe nama-aches omzimba, ama-acry muscle, ikhanda, nezimpawu ezifana ne-flu.
Lezi zithinta ngokuvamile zima ezinsukwini ezimbalwa ngemuva kwesilinganiso sokugcina semithi yokuvuselela i-stem-cell.
Izinkinga ze-PBSCT
Kunezinkinga eziningi ezikhona ze-PBSCT. I-high-dose chemotherapy ngaphambi kokufakelwa kubangela ingozi enkulu yokutheleleka ngenxa yokuntuleka kwamangqamuzana amhlophe egazi (ukukhulelwa komzimba) kanye nezinkinga ezihlobene nokungabi khona kwamaseli abomvu (i-anemia) namaplatelet aphansi (thrombocytopenia).
Ingozi evamile ngemuva kokufakelwa isifo sesifo se- graft versus host (GvH), okwenzeka ngezinga elithile cishe cishe wonke ama-stem cell transplants. Ku-GvH isifo amaseli asetshenziselwa (kusuka kumnikeli) aqaphela umphathi (umamukeli wokufakelwa) njengezwe langaphandle, nokuhlasela.
Ngenxa yalesi sizathu abantu banikezwa izidakamizwa zokuzivikela ngokulandela ukufakelwa kwe-cell stem.
Kodwa izidakamizwa zokuzivivinya nazo zibeka ingozi. Ukunciphisa ukuphendula kwamagciwane ngenxa yalezi zidakamizwa kwandisa ingozi yezifo ezinzima, futhi kwandisa ingozi yokuthuthukisa ezinye zegciwane.
Ezinye izindlela
Ukusebenzisa i-PBSCT kuyinkambiso enkulu. Akukhona nje kuphela okuphambi kwe-chemotherapy enobudlova kakhulu, kodwa izimpawu zesifo se-graft versus host, kanye nezinkinga zezidakamizwa zokuzivikela ziyenza inqubo evame ukugcinwa encane, futhi ngokujwayelekile inempilo, abantu.
Enye into engabhekwa ngayo iziguli asebekhulile noma empilweni ephathekayo yindlela yokufakelwa kwe-stem cell cell engekho myeloablative. Kule nqubo, esikhundleni sokuqeda (ngokuyisisekelo ekubhubhiseni) umnkantso wamathambo one-dose chemotherapy ephakeme kakhulu, isisindo esincane se-chemotherapy sisetshenziswa. Imfihlo ngalezi zindlela zokuguqula empeleni ilele uhlobo lwesifo se-graft versus host. Noma kunjalo, esikhundleni se-graft - amangqamuzana e-stem asetshenziselwa ukuhlasela - ukuhlasela amangqamuzana "amahle" emzimbeni owamukelwayo, amaseli asetshenziswe kabusha ahlasela amangqamuzana anomdlavuza emzimbeni womamukeli. Lokhu kuziphatha kubizwa ngokuthi "ukufakelwa kwe-graft vs.us tumor."
Obeye aziwe njengo:
I-PBSCT, I-Peripheral Blood Stem Transplantation
Imigomo ehlobene:
I-HSCT = i-hematopoietic stem cell transplantation
I-HCT = i-hematopoietic cell transplantation
I-SCT = ukufakelwa kwe-cell stem
I-G-CSF = I-Granulocyte-koloni evuselela isici - isici sokukhula, imithi yokuqinisa i-stem, ngezinye izikhathi inikezwa kubaxhasi ukuba bahlanganise amangqamuzana e-hematopoietic stem avela emnothweni wegazi kuze kube segazini legazi.
Imithombo:
I-National Cancer Institute. Ukufakelwa kweStem Cell. Kubuyekezwa 04/19/15. http://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant
Singh, V., Kumar, N., Kalsan, M., Saini, A., no R. Chandra. Indlela yokukhishwa: Ama-Stem Cell Stell (i-iPSCs) ayenziwe. I-Journal yama-Stem Cell . 2015. 10 (1): 43-62.
Wu, S., Zhang, C., Zhang, X., Xu, Y., no-T. Deng. Ingabe i-peripheral igazi noma umnkantsha wamathambo ungumthombo ongcono wezingqamuzana ze-stem zokufakelwa kwezitshalo ezimweni zabanikeli abahlanganiselwe be-HLA? Ukuhlaziywa kwe-meta. Ukubuyekeza Okubalulekile ku-Oncology ne-Hematology . 2015. 96 (1): 20-33.